The comprehensive & flexible RCM solution
Our flexible consultative approach, combined with our end-to-end services and specialized back-office team, meet your needs head-on. Let us help your medical group improve profitability and eliminate administrative burdens.
Patient appointment
Revenue Cycle Management (RCM) begins with a patient appointment. A patient can get an appointment on call by giving necessary information such as patient demographics and insurance information.
Eligibility & benefits verification
After the appointment, the patient eligibility and benefits are checked with patient insurance to verify that the services will be covered or not by the insurance.
Medical transcription
Recorded services convert into medical records. These medical records support the services, and insurance companies may also ask for medical records to check the medical necessity of the services.
Medical coding
Medical coders review the complete medical records and convert them into codes for diagnosis. ICD coding system, procedures, CPT and HCPCS are used. A medical coder handles these codes.
Charge entry & billing
Once all the information needed to complete the claim has been gathered, it is time to file the claim form.
Claim submission
After the charge entry, it’s time to send the claim form to the insurance Company for payment.
Paper claim submission Electronic claim submission
Online claim entry
Claim rejections
The claim rejection can occur due to several reasons. Medical billing experts review and correct claim rejection and re-submit claim to insurance.
Payment and posting
A claim follows all guidelines approved for payment. When the claim gets approved, insurance sends paid EOB or ERA along with payment.
Secondary claim submission
Patient primary insurance usually does not pay 100% of the allowed amount. The medical biller submits the claim to the secondary insurance of the patient.
Denial management
The revenue management cycle looks very smooth, but it is not. Many claims got denied due to different reasons fixing those denials is the responsibility of medical billing experts.
Medical appeals
When an insurance company denies a claim, the medical biller acts under the rules and regulations on refusal. Many insurers also offer second-level appeals.
Refunds (insurence & patient)
In medical billing, a refund is giving the money back to the patient or insurance company.
Patient Refund
Insurance Refund
