United States
Comprehensive Revenue Cycle Management
AccRevMed Solutions offer our clients comprehensive Revenue Cycle Management Services by handling all responsibilities internally and taking complete accountability of overall collection for the physician’s groups, private practitioners, and/or Hospitals. Our End to End services includes all administrative and clinical functions that contribute to the capture, management, collection of patient service revenue including handling complex process 24/7 with specialized agents and proprietary technologies to manage healthcare provider revenue cycles. Our successful revenue cycle management relies on measuring key rates and statistics and setting regular goals to measure the efficacy of workflow changes and updates to existing protocols.
Provider Enrollment Services
Provider enrollment is the first step in the revenue cycle, without an efficient and effective plan in place for healthcare organizations to enroll their practitioners with health plans the revenue cycle suffers. Each payor has different rules, regulations, processes, timelines, and seemingly unnecessary roadblocks that stall the process. You just need your doctors to be billable, your new physicians enrolled, and your growing claims on hold reimbursed. Trust the experts at AccRevMed to help you navigate the difficult process of provider enrollment and medical credentialing all at a low cost!
Verification of Benefits
The process of verifying the patient’s covered benefits and active medical coverage with the insurance companies, which is an essential step in the revenue cycle process to ensure timely billing and provides the foundation for proper coding and requirements for patient billing. It also helps to alleviate surprises along the way and can be used in cases where appeals may need to be written. We at AccRevMed Solutions follow the procedures strictly to verify the patient’s benefits and coverages and update providers/hospitals proactively before providing adequate care. As well as, follow through with the process until the claim is paid.
Pre-Authorization inquiries and approvals
What can your organization do with an extra 15 hours per physician per week? That is the average amount of time spent a week by the provider to complete a prior authorization or approval. This can be the most difficult and time-consuming process our medical professionals face currently. Our team of experts eases the burden by providing end-to-end visibility, from the time of approval to claim payment. We submit documentation on your behalf and work directly with the payers to approve your requests. We free up your staff and physicians, to focus on other important tasks such as the actual care of the patients.
Demo and Charge Entry
A critical part of the Medical Billing process is entering patient's demo and charges accurately, as the quality of work determines the number of rejections, denials, and finally the reimbursement of current AR. Our quality of service and knowledgeable staff help us to gain 100% confidence from our clients, while also being able to work round the clock to meet their expected turn-around times. We set goals and achieve complete entries within 24 hours of TAT. Our 24-hour turnaround time plays a huge role in increasing revenue, maintaining timely submissions, and ample time for the follow-up to receive a payment within the first 45 days of the claim being submitted. The most amazing part of outsourcing this service to us is all your claims will be billed before staff even logs in the next day.
Analytics
Today’s era can be defined as the “era of Data Analytics” especially in the healthcare industry as it can help to explore many areas and make a big impact on economic growth, create opportunities and improve efficiency in the health care business. Data analytics provides an in-depth analysis and emphasizes its usage to help look at the past to improve upon its services in the future, however, a positive impact can only be gained, if it is analyzed and utilized properly. We at AccRevMed use Data Analytics as a resourceful tool to analyze complex and challenging data and provide solutions to our clients using trends, specialty preferences, and other useful information. Our business intelligence algorithms and data mining help to provide an approach to reach a conclusion to our clients.
Medical Coding
The Medical Coding system plays a vital role in modern healthcare operations and is a major factor in obtaining insurance reimbursement, as well as, maintaining patient records. A perfect system and our quality of service communicate effectively with other healthcare systems throughout the US. Incorrect coding and erroneous errors can be costly and delay claim payments and can cause a reason for your organization to be audited. Our CPC Certified coders ensure accurate coding based on the CMS/AAPC guidelines and take complete accountability for claims not getting denied for incorrect coding-related issues.
Accounts Receivables Management
An effective Accounts Receivable Management system helps healthcare organizations to keep a close watch on payment trends/budgets, open AR, and payer denial trends. AccRevMed will keep you informed and will provide options to pull various reports to plot and identify the actual pending AR, improvements for any payer denial trends which will eventually help an organization to improvise reimbursement rates. AccRevMed provides a solid solution to your pending AR and resolves them by identifying the root cause of the issue and convert them into cash.
Our skilled multi-tasking resources utilize available options to complete a timely review of claims submitted. Including, but not limited to, utilizing the insurance IVR, checking status/appealing and/or initiating review via Insurance Websites, handling of Denial Correspondence, reviewing not only the status documented but previous follow-up history to assist in the resolution of a claim that may need escalation. We ensure limited touches on claims, avoid duplication, and a strong/aggressive follow-up tactic that will assist us in addressing more volumes and increasing your cash flow.
Our expert AR Resources handle and address Old aged and High $ AR claims as a priority, bring down days in receivable, and ensure timely payment.
Our aggressive intense professional approach on appeals, including but not limited to, providing clear documentation to support claim appeal is impeccable, which in turn, helped us resolving the most complex claims within your organization.
Our internal system keeps a close watch on Insurance appeal and submission deadlines and alerts us in avoiding dead claims. All the time that goes into one claim from the time a patient presents for services to the time the claim is paid is worth every effort to deliver results on every claim payment for your organization without delay.
Aged Accounts Receivables Recovery
The process of collecting the OLD AR due to either new system migration or inefficient follow-up by current staff and/or vendor. This is complex process, which requires an aggressive team with excellent analytical skills, in-depth knowledge in insurance guidelines/procedures and specialized in current procedural terminologies.
We provide a comprehensive and tailor-made services to clients in recovering OLD accounts receivables using our expert team. Our unique approach starts from.
Access to PMS and AR Reports: Getting access to client’s Practice Management System and run the required reports to identify and set goals on collections.
Analyzing: Review the AR report and trend the pending AR by AR aging, Payer, provider and High $ Value to assist in project management
Claims Prioritization and work Allocation: Plug in Timely Filing Guidelines to existing claims to better assist in recovery of claims while prioritizing claims that may be close to those limits in-order to focus on claims which is nearing filing deadlines. Allocation of work in bulk to address claims got affected for global reasons and for speedy recovery.
Identifying Collectable and uncollectable: Separate collectable and uncollectable AR for clear focus to ensure our staff is spending time working claims that can be recovered while discussing a plan with the client on possible claims that cannot be reimbursed by payer due to past appeal and filing deadline, non-payable codes and exclusive guidelines from the payers.
Setting Follow-up Date: Setting follow-up date for subsequent follow-up and identifying alternate phone number for unable to reach payers.
Regular Reviews for transparency: Sharing daily reports and review the progress with client in a weekly basis and provide transparency.
Patient Statement Generation: Billing patient/member for claims they are responsible for and send required statement for self-pay collections.
Posting Payments: Posting Payment on request for claims that are paid and share the recovery progress report with the clients. Automating processes within the system to ensure timely patient collections.
Payment Posting
The process of posting payments in client practice management system based on the Explanation of Benefits [EOB], EDI errors and Payment Checks received either from insurances and/or patients. We at AccRevMed has a strong payment posting background with over 20 years’ experience working with leading Practice Management Systems, which reduces training times. We not only will post payments, allocate funds accurately, clean up your clearing house but we will also provide reporting and analysis in areas of improvement within your billing system to reduce turn-around in payment allocation. If necessary, we have adopted some practicing within our company to contact carriers that may not have clear path in posting to resolve any unapplied funds and/or initiate credit recoveries based on client approvals.
Patient Billing and Collections
The final phase of the billing process is ensuring bills get paid and then following up with patients whose bills are delinquent and get them recovered. Given the rise in high-deductible health plans, along with decreasing payer reimbursement, patients are being held increasingly responsible for larger portions of their healthcare bills. In turn, healthcare organizations are realizing the importance of a strong patient collections effort. We at AccRevMed strictly follow-through the best practices of
Developing a proactive strategy by:
- Monitoring collections
- Communication with patients to be on the same page
- Training internal staff on handling patient calls
- Up to date with Insurance updates
Implementing payment plans and offering incentives
Tracking performance to ensure providers get their bills settled at the earliest
“Skip tracing” process to locate unreachable patients and ensure they are receiving undeliverable mails
Payer Solutions
We are proud to extend our services to the Healthcare Payer side and ensure our solutions help payers to make quick adjudication decisions. We follow CMS and CAG guidelines strictly to avoid delays in processing medical claims and Our skilled professionals act as a true support center in providing clear communication to members and billers. Please reach out to us to get to know more: