Healthcare Revenue Cycle Management
Revenue cycle management (RCM) is the financial process that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.
As a part of Revenue cycle management (RCM) we manage claims processing, payment and revenue generation.
We entails using latest technology to keep track of the claims process at every point of its life, so that healthcare providers or medical billing companies aligned with us can follow the process and address any issues, allowing for a steady stream of revenue.
Our process includes keeping track of claims in the system, making sure payments are collected and addressing denied claims.
Our RCM process encompasses everything from determining patient insurance eligibility and collecting co-pays to properly coding claims using CPT and ICD-10 codes.
We strictly adhere to time management and efficiency as a key role in RCM.
Outsourcing the billing process to a medical billing service company helps you to take better care of patients. It also generally increases the amount of accepted claims and payments.
The best medical billing services can help in meeting national regulations, such as ICD-10 coding transition and meaningful Use Stage 1 and Stage 2 certification, an easier and smoother process for your practice.
Outsourcing is a common practice when it come to medical billing. We as a medical billing firm has very good knowledge and experience to take care of all the medical billing activities and free your staff to concentrate on other ascepts of running the practice.
What you can expect by outsourcing your medical billing process:
Cash flow increase
Save on the high cost of equipment and software as rapidly changing technology translates into extra expenses
Reduce staff size and employees expenses
Eliminate sick pay, vacation pay, insurance benefits, workers compensation, etc.
Eliminate training costs
Reduce call volume
Focus on patient care instead of billing
No cash-flow interruptions due to staff turnover
Reduce costs
Eliminate “non-medical” business office space
Reduce record storage space
Receive detailed reports
Eliminate provider/patient payment discussion
Outsource medical coding services to Vectiv and experience the difference. Outsource medical coding services to Vectiv and benefit from cost-effective medical coding services. Outsourcing medical coding services to Vectiv can help you save on time, effort and resources.
Our certified coders are professional, skilled, and well versed in international coding practices. They constantly develop and refine internal compliances of contract ICD and CPT coding resources to meet the requirements of the customer.
All our coders are AAPC (American Association of Professional Coders) certified and have a minimum of 4 years of hands on experience in medical coding. Our efficient coders perform the coding for the handwritten physician's diagnosis on the charge sheet.
At vectiv we follow below medical coding standards:
CPT, ICD-10, and HCPCS coding across various specialties.
Insurance and governmental regulatory requirements.
Payer-specific coding requirements.
Software like ENCODERPRO, VectivCode (our Internal Medical coding database) etc.
Advantages of Outsourcing medical coding services to us:
Increase in cash flow and improvement in claims submission.
Reduction in cost and administrative burden
Optimized revenue possible
Compliance risk is reduced
Team with in-depth knowledge about revenue cycle management
Seamless integration with Medical Billing System
SCHEDULING :
First step of the encounter‐ involves making the appointment and setting up the account to prepare for billing and contact.
Collect: Contact info, Demographic information, Insurance info and Reason for visit.
Pre Authorization :
Using the info provided at booking to verify eligibility and pre‐authorization for the appointment. This step helps to identify data entry errors or missing info.
Using the billing info captured at booking, we contact the insurance carrier to determine eligibility and seek pre‐authorization for specific visits/providers.
Insurance Verification & Authorization:
Verification goes beyond simple insurance eligibility.
Our methods ensure appropriate plan attribution and coverage benefit levels, all in an automated rules-based process.
Our technology and operational processes are both sophisticated and flexible, focused on preventing unnecessary service delays.
Prepares the account for accurate billing, ensures coverage is active at the time of service.
Identifies the amount the patient is obligated to pay in the form of deductibles, co‐payments or co‐ insurance..
Charge Capture/Coding:
Documenting and coding all services and capturing as charges. Clinical care documentation should match coding and charge capture.
Appropriateness of care sheet is important to a more efficient healthcare system for all.
Collaborative techniques and expertise align incentives, provide transparency, and ensure appropriate patient classification.
Claims Submission & Insurance Billing:
Preparing and submitting the claim to clearinghouse or direct to payers.
Review charges and codes, verify all charges are captured and posted correctly.
Our billing methods are differentiated through intelligent quality control to improve throughput efficiency and eliminate process defects.
Same-day error resolution, reconciliation, and collaboration across revenue cycle and clinical departments represent the best chance for a clean claim and effortless payment.
Receivable Follow-Up :
Tracking submitted claims to ensure receipt by payer. Taking appropriate action (modify, appeal or write‐off) in response to denials or partial payments.
Payer collaboration further ensures optimal payment outcomes and process efficiency.
We have extensive experience in maximizing payer reimbursement through proven approaches to receivable segmentation, continuous feedback, and high-quality, consistent resolution methodologies.
Same-day error resolution, reconciliation, and collaboration across revenue cycle and clinical departments represent the best chance for a clean claim and effortless payment.
Denial Prevention & Appeals:
Our technical and clinical denial expertise enables high effectiveness in denial and write-off prevention.
Our analytical approach to detecting underpayment or partial pay opportunities ensure efficient resolution of reimbursement gaps.