Revenue Cycle Management (RCM) Billing Services
Promantra's comprehensive Revenue Cycle Management (RCM) services help increase and streamline compliance while saving your money. Our proven capabilities accelerate your company’s revenue cycle to increase your productivity, speed payments, decrease costs and improve patient service. In addition, our experienced health-care team analyzes Explanation of Benefits (EOBs) and claims and acts immediately to recover the due amount. All of which means you can focus on your core business - providing better health care. Below is the staged representation of our end-to-end RCM Billing Services.
Promantra’s End-to-end Revenue Cycle Management (RCM) Billing Services
- Patient Demographics Entry: Capturing patient's name, address, SSN, Employer and Insurance Information.
- Insurance Eligibility Verification: Insurance information obtained during admit /registration process is verified with the Insurance/third party carriers.
- Charge Entry: Charge entry is carried by gathering all charge documents from all departments, within the facility that have provided services to patients.
- Coding: All documents are reviewed for the services provided and appropriate ICD-9-CM are assigned, also CPT-4 codes as applicable are assigned.
- Claims Processing or Billing: Gathering claim information and generating appropriate claim form. Claims are processed electronically or manually to insurance carriers with the information necessary for reimbursement.
- Patient Billing: After final payment has been made by the insurance carries, the accounts are assigned to representatives, to invoice patients, and notify the patients with follow up reminders, of their responsibility to pay and arrangements made for payment.
- Collections: When patient payment is not received in a timely manner, collection activity on the balance of the patient account will begin.
- Payment Postings: When payments are received, the appropriate payments and insurance carriers are posted to the patient accounts along with any patient payments until the balance has been satisfied.
- Denial Management: The difference between facility charge an payment received is obtained through the EOB, Explanation of Benefits received from the insurance/third party carriers. Determination of whether appropriate reimbursement has been made, and if not, an appeal, a formal request for reconsideration is made.