RCM Services Designed for Healthcare Providers
At PulseCheck, we understand how overwhelming the revenue cycle management process can be. Our RCM services are designed to help you improve billing and collection at your organization, so you can increase profit and put your attention where it matters most — on your patients.
UrgiChart delivers RCM services (powered by CareCloud) that enable practice providers, managers, and owners like you to enhance financial performance by mitigating costly billing and coding errors. When you leave your revenue cycle management to our team, you shift the burden of collections off of your team, making room to focus on quality patient care while simultaneously increasing profitability for your organization.
Systems and Setup
- Process map the Revenue workflow
- Document billing and coding nuances
- Establish communication protocols and expectations between Comapny and Client
- Review Clients bad debt and contractual write-off protocols, provide input and suggestions on possible modifications, and implement such protocols
- Review the setup of the system scheduling and billing system (PMS)
- Assist Client in setting up a bank lockbox service if need be
- Review and advise on billed charge fee schedule(s)
- Review the coding compliance process and suggest recommendations for improvement
- Review the clearinghouse system to ensure it is set up correctly
Billing
- Provide quality checks
- Confirm patient demographics are complete
- Confirm procedure codes and diagnosis codes are valid and logical with regard to the nature of the claim and patient
- Biller verifies the correct billing format, assigning the proper modifiers and submitting all required documentation for the claim
- Process claims electronically via the clearinghouse (unless the payer does not have electronic claim
- Correct any claims that are rejected by the clearing house edits
- Provide Client a method of auditing files to verify proper billing
Payment Posting
- Receive EOB data from Client (via lockbox or scan and electronic remittance adivce -ERA)
- Reconcile EOB data provided by Client and post payments for each procedure based on such data
Collections, Appeals and Followup
- Appeal, fix and re-bill denied or partially paid claims based on EOB data
- Provide information to allow for coordination of refunds as required to payers and patients
Live Denial Management
- Follow-up on all denials received at the Posting stage within 48 hours of receipt
- Reports are in real time on our platform, and fit your custom requests. Specialists follow up with payers and update our rules enines to reduce denial rates
Patient Bills
- Coordinate statements on a monthly basis
- Protocol for patient statements is to be defined within reasonable and industy standard business limits
Reports
Detailed claim issue (DCI) reports can be sent on a daily to weekly basis as required identifying:
- Services that were unable to bill due to missing information, illegible information, etc.
- Uncollectible accounts
- Collections and services by rendering provider
- any other reports as reasonably requested by client that do not require custom software programming
- Reports of monthly collections to reconcile to CareCloud's invoice
- Send Month End Practice Performance Reports
- Provide any ad hoc management reports as required by Client (subject to Service Fees)
Revenue cycle management is essential to the financial viability of your organization. Are you doing everything you can to maximize your collections and increase your profitability?
Our RCM services will help your healthcare organization reduce its A/R and improve its overall financials. From professional input to quality checks and end-of-month performance reports, our team will do everything we can to support you in your long-term success.