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Healthcare Revenue Cycle Management


Holistic Revenue Cycle Management

There are no heights to measure a hospital in terms of it’s service, However gauging whether the hospital is successful or not is relatively easy; one needs to take be cognizant of the organization’s financial state. Irrespective of the genre of the corporation: hospitals, small practices or larger healthcare systems; Revenue Cycle Management is a key result area. We at Promed strive towards being par exemplar vis a vis our services and thereby giving our clients a world-class user experience. Today, the citations obtained by means of the latter fuel the exponential growth at Promed. Our numero uno priority as a service provider is to enable sustainable cashflow optimization for our customers; even as we acknowledge the constraints of the framework, extrinsic inhibitors: those externalties that function as headwinds. We offer end to end solutions in the medical billing industry. As a provider you get to carry out patient care with a laser beam like focus.

Strategic Revenue Cycle Management

Curated processes to give all stakeholders that whoa moment. During the course of billing when periodic audits are not carried out there are high odds for the incidence of denial. Revenue Cycle Managment starts with scheduling, patient verification and continues up until culmination at patient’s payment collection.

The program is set in motion prior to the patient booking an appoinment at our patron’s office. We are proud of our industrious executives who constantly scout for denied claims and
diligently work towards resolution

Our Services include

  • Appeals and Denial Management
  • Charge Claim Submission
  • Monthly Client Revisions
  • Consulting Services – practice management and clinical
  • Credentialing/Re-Credentialing Assistance
  • ERA and Payment Reconciliation
  • Insurance Pre-certification, Pre-authorization, and Pre-determination processes
  • Patient Statement
  • Remittance Processing/Lockbox Management
  • Coding Assistance
  • Standard and Custom Reporting
  • Patient Eligibility & Verification
  • Referral and Authorization

With RCM you can directly schedule and manage the appointment while creating the profile.

  • Insurance Eligibility Verification

Within a second you can check the insurance eligibility of the patient while they are going for any treatment.

  • Pre Authorization Number

While creating their profile you can give and have their authorization number.

  • Demographic Entry

Know from where they came from directly with our software.

  • Medical Coding

Decrease error and work on automated software to smooth working With our best coding and software avail smooth management of patient entry.

  • Charge / Cash posting

Billing is not an issue with our services directly get the payment and manage the billing process through automatic software.

  • Denial Management

With every information know the exact reason for denial and resolve at the same time.

  • Accounts Receivable / Management

Now directly manage the amount received and pending amount while they pay

  • Aged Accounts Receivable / Clean-up process

Know about every small detail through their profile

  • Patient Billing / Follow-up

Directly follow up with them through the system without any trouble as every single detail are listed there.

Our aim and vision are to deliver the most influential, flexible, fully wide-ranging Revenue Cycle Management Services possible. Our RCM services achieve revenue functions within physician practices and hospitals. Our RCM is dependable, gainful, billing and collections to reach your economic objectives. For additional information, download our information piece, or reach us directly.

The revenue cycle management is continuously evolving over the years to keep up the pace with changes in the healthcare industry. More technology solutions emerge to address value-based payment models and the revenue cycle management services is becoming more important as there is rise in popularity of high deductible health plans.

There are now more solutions and technology geared toward risk adjustment tracking and coding. Most of the vendors, track and manage new payment methodologies and models. They are providing innovative solutions that will track receipt, disbursement and compliancy of bundled payments when different partner organizations and disparate technology platforms are involved.

It is becoming very important for the providers to make the care affordable as more health plans are moving towards more responsibility towards patients’ cost care. The revenue cycle is also to refine value-based care with advanced analytics. These analytics will be able to facilitate a patient’s understanding of insurance coverage and out-of-pocket cost for pending services that will feature prominently in the future.

Healthcare organizations will require sophisticated analytics to boost practice management system and revenue cycle management of medical group practices. These analytics will pinpoint opportunities for additional profit, as well as value-based contracts which will offer optimum return.

When it comes to productivity, the healthcare providers are lagging behind due to the nature of healthcare industry, workflow, stability, and security factors. The providers have now learnt the advantages that are associated with outsourcing their technology or medical billing requirements.

Denial management team uses unique technology-based analytics by analyzing and reporting from where the errors originated, then goes to monitoring and implementing the solution. Followed by appeal procedures where a qualified team is appointed to research the reason of appeal that can impact insurance decision. The final step is healthcare monitoring that scans numerous external factors which impact providers’ cash flow and result in denials, such as, payer policies, CMS initiatives, state legislations etc., which keeps the providers/patients updated with the challenges and recommend solutions.

ProMed Intel Healthcare delivers superior outcomes to its clients through Accounts Receivable by:

  • Reducing outstanding Pending claims within 90 days
  • Increasing providers’ collection by more than 10%.
  • Resolving  claims in couple of follow-up
  • Reducing accounts receivable in days by 25%
  • Utilizing  the knowledge gained after a years of experience in working with all major insurance
  • Having expertise in all major hospital and physician billing systems