Skip to content

Revenue Cycle Management

Revenue Cycle Management (RCM)!

Revenue cycle management (RCM) is a process used by healthcare providers to track the revenue from patients, starting from their initial appointment with the healthcare system to their final payment of balance. The major processes that comprise the revenue cycle management, which are carried out at RND, are – sorting of incoming faxes, data entry, intake, insurance verification, prior authorization, sales order creation, billing, accounts receivables followup, and payment posting. RCM ensures a steady flow of revenue for the healthcare providers.

RCM encompasses everything from determining patient insurance eligibility and collecting co-pays to properly code claims using ICD-10. Time management and efficiency play pivotal roles in RCM, and a physician’s or hospital’s choice of an EMR will largely center on how their RCM is implemented.

Staffing Services We Offer

  • Fax documentation

    Reviewing the received member faxes from referral sources, determine the missing medical documents and forward to verification based on the prescription.

  • Intake

    Process patient fax from Doctor’s office, create account for the patient in the client tool, complete verification, initiate authorization and log the approved prior authorization.

  • Sorting / Filing

    All the clinical records received from doctor's office are filed in respective folders for future reference. New folders are created for new patients with all demographic details.

  • Insurance Verification

    Calls are made to the insurance company to check for patient's individual and family benefits, policy termination date and coverage limit to determine whether the patient is eligible for machine/supplies.

  • Pre Auth/Pre cert

    Pre cert is obtained from the insurance company based on the patient's usage of the machine. This process will ease the submission of claims and guarantees payment without any further delay.

  • Sorting / Filing

    All the records like insurance, prescription, sleep study report and other clinical records received from doctor's office are filled in respective folder for future reference. If it is for a new patient new folders are created with all demographic details.

  • Patient Calling

    Calls are made to patients intimating them that they are eligible for their resupplies based on their allowables.

  • Inbound Calling

    Attending incoming calls from patients regarding billing, supplies and other queries.

  • MCR Checklist

    All documents are checked and ensured that available documents are as per the Medicare approved criteria.

  • Billing

    It is the process of generating invoice for the machine and supplies that patient's bought from the DME. The billing will be sent to both patient and the insurance.

  • CMN Follow-up

    Calling patients or doctor’s office to get the missing necessary medical documents for approval of Shipment/supplies.

  • Shipping Ticket/order entry

    Once insurance is verified, based on the insurance eligibility and patient's request, shipping ticket is created for the eligible machine and supplies.

  • Initial Order

    When a new patient goes to a provider for getting equipment or supplies, we check eligibility and other mandatory documents like prescription and add the required supplies.

  • Order Processing/Resupply

    When a new patient goes to a provider for getting equipment or supplies, we check eligibility and other mandatory documents like prescription and add the required supplies.

  • Payment posting

    We are posting payments received from insurance and patient into client application in both electronic and manual payments.

  • AR Follow – up

    Analyzing the denied claims and probing for the exact reason and resubmitting it to the insurance carrier with the necessary corrections.

  • Returns refunds

    Refunding the payment for the returned supplies to the patient and the insurance company. Refunding the over payment made by the insurance and rebilling the extra amount recouped by the insurance.

BENEFITS OF PARTNERING WITH US

  • Zero set up cost

  • Improve cash flow cycle

  • Saving more than 60% on operating costs

  • Quick support ensuring faster turnaround time

  • Experienced personnel will handle your revenue cycle management

  • Continual follow up of your bills and records for better revenue collection.

  • HIPAA compliant proven processes for high performance revenue cycles.

  • State-of-the-art software and technologies for a highly productive functioning of your revenue cycle management.

  • Risk free business support services ensured by stringent information security policies and practices.

Frequently Asked Questions

FAQ!

The business world is being flattened by economics, technology, demographics and regulations. To win in this flattening world, companies must transform their way of working to seek and convert new opportunities wherever those opportunities may be. This means acquiring the ability to disaggregate your operations, people and resources across time zones, geographies, cultures and sourcing and delivering.

  • Why should I outsource to RND?

    By outsourcing to RND, you will experience an immediate reduction of up to 60% in your manpower costs. We provide staff to take care of your front end and backend operations. This will enable you to focus on growing your business without having to worry about increasing operational costs, employee attrition, etc.

  • What are the services you offer?

    We offer entire Revenue Cycle Management – a few of them being, data entry, insurance verification, authorization, Dr’s office followup, intake, order processing, billing, denial management, payment posting, inbound and outbound patient calling, etc.

  • Where are you located?

    We are located in Southern part of India.

  • Do you have physical presence in US?

    No. We operate out of India so that we can pass on the savings to our clients. We visit the US frequently to meet our clients.

  • Do you have experience of working in the healthcare industry?

    Yes, we have more than 22 years of experience working in the US healthcare industry. We have been providing medical transcription services to hospitals across the United States since 1999 and DME/Home care back office services since 2012.

  • What is your onboarding period for a new employee/customer?

    Anywhere between 1 to 14 days.

  • Do you follow US holidays or local?

    We follow US holidays.

  • What would be the FTE’s working hours?

    The FTE would work the US working hours, in the time zone of your choice.

  • Is the contract obligatory? Is there a minimum or maximum contract period?

    No, the contract is not obligatory and there is no minimum contract period. The contract simply states that the two companies are entering into a partnership for the providing and receiving services. You can terminate the contract if you are not satisfied with the services. A notice period of 1 month is appreciated but not mandatory.

  • Are you HIPAA compliant?

    Yes, we are certified for HIPAA and Information Security Management Systems.

  • Do you have a trial period?

    Yes, we offer a one-month free trial period with 1 FTE

  • Is there any contract to be signed before getting started?

    No, the contract is not obligatory and there is no minimum contract period. The contract simply states that the two companies are entering into a partnership for the providing and receiving services. You can terminate the contract if you are not satisfied with the services. A notice period of 1 month is appreciated but not mandatory.

  • Do you follow FTE based billing or percentage of revenue generated billing?

    We follow an FTE-based billing. One FTE (full time employee) works 8 hours a day, 5 days a week – a total of 40 hours a week.

  • How will I be billed?

    You will be sent an invoice each month mentioning the number of FTEs agreed upon and the services provided.

  • How can I make payments?

    You can make payments through Paypal using your credit card or make a wire transfer.

  • Are the FTEs your own employees or do you subcontract to other smaller companies?

    All our FTEs are employees of RND and are dedicated to each client, the agent will not be shared with other clients

  • Do you follow your own guidelines while working for different customers?

    No. We follow Standard Operating Procedures (SOPs) created by the customers. If the customer does not have one, we create and get approval from them before starting the process.