US Healthcare Revenue Cycle Management

Revenue Cycle Management Services

M2ComSys has been a leading provider in revenue cycle management services to medical practices. We partner with healthcare organizations to improve and accelerate reimbursements, prevent denials, arrest revenue leakage, and improve the patient experience. We leverage our team of industry veterans to ensure every aspect of the revenue cycle is processed in the most efficient and effective manner possible. We help you get your revenue cycle back on track, reducing costs and driving revenue.

Verification of patient Eligibility and Benefits

Our team is well versed in verifying the eligibility and benefits of patients telephonically, through insurance websites or IVR/IM systems provided by payers since it is imperative at the time of scheduling to gather as much information about the patient’s insurance carrier with which to verify benefits.

Charge Entry and Medical Billing

Our medical billing team has expertise electronic and paper claims submission help you bring in valuable revenue.

Payment Posting

We process the following types of remittance transactions with an exceptional degree of accuracy and timeliness:

  • Electronic Remittance Advisory (ERA) Posting
  • Manual Payment Posting
  • Denial Posting
  • Posting Patient Payment

Work Handled By Team

Denial Management and AR Follow-up

Our AR voice and non-voice follow up teams analyze and perform timely follow-up on the outstanding balance in patient accounts, by making calls to insurance companies. We aim at reduction of ageing AR queues, thereby improving cash inflow and collection ratios of the customer. We review the patient records meticulously in order to address and rectify any denials from insurance.

ELIGIBILITY VERIFICATION AND PRIOR AUTHORIZATION

The process of verifying benefits and eligibility of a patient(provided the benefits for the provider’s specialty are available online on the insurance website) or telephonically via an IVR or a live representative. It is imperative at the time of scheduling to gather as much information about the patient’s insurance carrier with which to verify benefits. Utilizing our referral and pre-authorization services confirms that the patient is approved for the planned service or procedure before arrival, ensuring that the first stage of the revenue cycle is completed accurately. Doing so sets the rest of the claims process up for success

PATIENT DEMOGRAPHICS, CHARGE ENTRY AND MEDICAL BILLING

We deliver unmatched expertise in the claim submission process, starting from demo/charge entry until the submission of claims electronically, through paper or via fax. Our charge entry team deals with the billing work for major US healthcare providers. Every member of this team is trained in medical transcription. This team takes care of assessment of doctor’s notes, interpreting them using logical reasoning and a detailed knowledge about the latest ICD/CPT codes, calculating the costs, and entering the charges for billing purposes

CLAIM REJECTION MANAGEMENT

Our edit resolution and claims experts navigate the electronic claims submission process to ensure rapid payment of healthcare claims. Our services assist health organizations to:

Credit Balance

Our team carefully reviews any overpayments and validate any other reason for credit balances on patient accounts thereby taking necessary action towards its resolution.

PAYMENT POSTING

The process involves recording payment details as received from the insurance company (in the form of an EOB or an electronic remittance advice-ERA) and the patient. It is done in order to maintain a record of the payments received and also to work on the denials/pending claims if any and the necessary follow-up.

DENIAL MANAGEMENT AND ACCOUNTS RECEIVABLES FOLLOWUP

Our AR voice and non-voice follow up teams analyze and perform timely follow-up on the outstanding balance in patient accounts, by making calls to insurance companies. We aim at reduction of ageing AR queues, thereby improving cash inflow and collection ratios of the customer. We review the patient records meticulously in order to address and rectify any denials from insurance. Our specialties include:

CREDIT BALANCE

Revenue cycle credit balance review includes the identification and resolution of any credit balances that may have occurred during a billing cycle. Credit balance review is required and regulated by law and helps clean up unnecessary open accounts on your A/R. If accounts receivable reports have unresolved credit balances, it results in miscalculated revenue reports and pulls necessary resources off vital tasks to correct the issue. Additionally, failing to reimburse overpayments could potentially result in a fine, or worse, as multiple fines could result in serious financial noncompliance issues. These issues can be avoided by optimizing your revenue cycle and performing a thorough credit balance review

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