Revenue Cycle Management

Super-Charge Your Practice With Our RCM Services

Revenue Cycle Management is a broad term covering many aspects of the healthcare industry. RCM in medical billing is often considered a financial process, which is why many other services fall under the umbrella of RCM. The revenue-generating cycle includes medical billing, coding, and accounts receivable management services.

Outsourcing these services allows practitioners to have smooth administrative and clinical processes. Managing the healthcare revenue cycle is very complex and even more complicated for healthcare providers. We are here to help them share their hectic burden with us. Many other companies provide the same services. We stand out from them because we provide the same services but at minimal rates.

Our Custom Billing Solutions

Services And Process Automation Within The RCM Services

We collaborate with medical practitioners and clinicians, and our clients are from all over the USA. We help healthcare providers and organizations accelerate reimbursements. With our help, clinicians can figure out the root causes of revenue leakage. Next, we work likewise to remove them. By utilizing our services, you can improve patient experience. Our services span the whole revenue cycle management segmented into three categories.

This phase involves the patient, commonly known as the patient access area. The front-end process of RCM plays a vital role. It evaluates and ensures accurate, timely revenue collection. The steps involved in the front end of RCM are as follows:

Frontend Revenue Cycle Optimization

Patient Appointment Management and Scheduling
We manage patient appointments to reduce the number of patient no-shows and save practitioners time.
Eligibility Verification
We verify insurance coverage, eligibility, and benefits to ensure accurate billing and denial management.
Prior-Authorization
Our team manages the prior authorization process and ensures that our clients get the required approvals on time.
Patient Demographics
We efficiently manage patient registration and demographic data. This service is very beneficial for submitting claims on time and accurately billing.

Mid-Revenue Cycle Services

Initial Auditing and Charge Entry
In the charge audit, we ensure nothing slips through, to get accurate billing and timely claims submission.
Medical Coding Services
Our ICD-10-certified coders proficiently assign accurate codes to medical procedures, and we can easily handle medical coding software.
Revenue Integrity
We maintain revenue integrity by conducting regular audits. We consistently review billing processes and claims submissions.
Medical Coding Audit
Our experts review billing data submitted by insurance payers. This helps identify, monitor, and correct mistaken or inappropriate coding errors.
Clinical Documentation Integrity
We are efficient improvers of clinical documentation and ensure the documentation complies with regulations.

Back End Revenue Cycle Services

Revenue Cycle Management Process

Finding an authentic and efficient RCM services provider is undoubtedly a big headache. Among a billion selecting a company that sits best on your requirements is quite a task. Premium Medical Billing Solutions LLC is a company that has already rendered the problems you might be facing. Collaborate with us if you want to achieve good revenue each month. For your assistance, we have initiated our process through which you can take the idea of how we get on to your goals. Our RCM process is demonstrated below for your assistance:

Revenue Cycle Management Steps

Eligibility Check and Demographic Verifications:
The first step while performing RCM services is an eligibility check or demographic verification. This is done to collect the patient's particulars for further proceedings.
Collection of Co-Pay/Balance:
This is the next step in which we collect co-payments which is the amount of money that a patient with health insurance pays for each health care service, it takes.
Claim Creations Validations and Submissions:
Is our core service. We create follow-ups and keenly work on the purposes responsible for denials. We opt for claim creation validations and submission very next which creates the right balance between discovering possible fraud and ensuring genuine patient claims are validated quickly.
Correcting Errors/Denials:
By utilizing the ability to provide premium denial management services we focus on denials next. Here we thoroughly check the claims, omit errors and do all verifications to avoid any hurdle while submitting claims.

Claim Follow-Up:
After submitting claims successfully we make follow-ups with the payor companies. If you do not have upgraded software that makes reminders for taking follow-ups we are here to help you.
Statement of the Patient:
We next send a bill invoice or statement to the patient on behalf of the provider to let it know how much insurance has been paid and how much is left that it has to pay to the provider.
Collecting Payment From Patients:
We also take the responsibility to collect payments from the patients. We also send reminders to the patients if they forget or delay the payments.

Frequently Asked Questions

How do you manage claim ageing?

Our proficient billers are qualified to manage claims from the early stages, reducing the buckets and detaining claim ageing.

How long does it take to get prior authorization?

It depends on the complexity of the prior authorization request. The level of manual work and the insurance company's stipulated requirements also matter here. We try to get this done in fewer days.

How do you submit claims?

We use the best EPM systems to submit claims. This allows us to follow up frequently and perform all essentials to reduce denials. We can also efficiently manage any EPM system that our client provides.

Can you work on pending claims?

Yes, we work on pending claims by offering a simple transition between in-process and pending or rejected claims left by your current vendor. We guarantee a smooth claim acceptance process without any disruption to your payments.

How much do you charge for medical billing services?

We offer customized medical billing services to providers. We have fixed-fee and percentage-based plans with the collection of as low as 2.77%.

Revenue Cycle Management

Super-Charge Your Practice With Our RCM Services

Our Custom Billing Solutions

Services And Process Automation Within The RCM Services

Frontend Revenue Cycle Optimization

Mid-Revenue Cycle Services

Back End Revenue Cycle Services

ADVANCED TECHNOLOGY

HOLISTIC ASSESSMENT

CONTINOUS IMPROVEMENT

CROSS-FUNCTIONAL COLLABORATION

Revenue Cycle Management Process

Revenue Cycle Management Steps

Frequently Asked Questions

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