Revenue Cycle Management
Rejected claims, denials, payment collections, follow-up & appeal management
Revenue cycle management is a standard process to resolve unpaid insurance claims. Our follow-up specialists investigate insurance carrier responses to determine why the services remain unpaid and take the actions necessary to receive payment.
Our RCM process:
- Review daily claim rejections and resubmit with clean claims
- Review carrier denials and respond with corrected claims, reprocessing requests, medical records, or appeals
- Prepare and provide timely statistical reporting to practice managers to address internal issues and help prevent future denials and payment delays
- Monitor the payment patterns of all major insurance carriers to avoid payment denials and ensure complete payment according to current fee schedules
- Electronic and manual posting of carrier payments, including follow-up on all incomplete, reduced, or adjusted claims
- Invoices prepared for all patient responsibility balances (i.e., patient deductible, termination of insurance coverage, co-insurance, etc.). To the extent that payment cannot be obtained through direct patient billing, unpaid claims may be sent to a collection agency
- Monthly reporting of all carrier payments, aging claims, and open issues
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