RCM Services

SERVICES

Optimize Financial Performance with Our Comprehensive RCM Solutions

Optimize your financial performance with our RCM solutions. We provide comprehensive services, including billing, coding, claims processing, and denial management, to ensure you maximize revenue and reduce administrative burdens.

01.

Patient Access

Insurance Verification: Ensuring patient coverage and eligibility.
Pre-Authorization: Obtaining approvals from insurers for specific procedures or services.
Patient Registration: Collecting and updating patient demographic and insurance information.
Scheduling and Pre-Service Financial Counseling: Estimating out-of-pocket costs for patients.

02.

Charge Capture

Documentation and Coding: Accurate clinical documentation and coding (ICD-10, CPT, HCPCS) for services provided.
Electronic Health Record (EHR) Integration: Linking clinical and billing workflows to avoid missing charges.

03.

Claims Management

Claims Submission: Preparing and submitting clean claims to payers.
Claims Scrubbing: Identifying errors to reduce claim denials.
EDI Transactions: Use of electronic data interchange for claims processing.

04.

Payment Posting

Remittance Processing: Posting payments from insurance and patients.
Patient Responsibility Determination: Calculating and communicating the remaining balance to the patient.

05.

Denial Management

Denial Analysis: Identifying root causes for claim denials.
Appeals and Resubmission: Correcting and resubmitting denied claims.

06.

Accounts Receivable (A/R) Management

Follow-Up on Outstanding Claims: Tracking and managing unpaid claims.
A/R Aging Reports: Prioritizing follow-ups based on claim aging.

07.

Patient Collections

Patient Billing: Generating accurate and timely patient statements.
Payment Plans and Financial Assistance: Offering options for patients with financial difficulties.
Online Payment Portals: Providing secure and easy payment methods.

08.

Compliance and Reporting

Regulatory Compliance: Adhering to HIPAA, CMS, and other regulations.
Quality and Performance Reporting: Monitoring RCM metrics (e.g., Days in A/R, Denial Rate, Net Collection Rate).
Audit and Risk Management: Ensuring accurate billing and reducing compliance risks.

09.

Analytics

Dashboards and Reporting Tools: For performance tracking and trend analysis.

10.

Business Intelligence

Predictive Analytics: Identifying potential issues and optimizing cash flow.

Welcome to MedCloud Technologies, Our focus is to empower organizations with cutting-edge technology that transforms the way they deliver care and manage information.

Optimized IT Solutions for Scalable, Secure, and Future-Ready Businesses