Healthcare revenue cycle management (RCM) is the financial process that facilities management of the administrative and clinical functions associated with medical claims processing, payment, and accounts receivable follow up. Without this key financial process, healthcare organizations cannot keep their doors open to treat patients. US healthcare constitutes of three entities, namely, patients, providers, and payers. Providers are hospitals, clinics, and practices where physicians, surgeons, nurses etc. work to provide healthcare to patients. Payers are insurance companies which collect premiums from patients as their members and pay healthcare providers treating their members.
RCM involves preparing claims to be submitted to payers, posting payments received against the claims submitted, and following up for accounts receivables. ACP takes pride in hosting the best of managers and specialists who are certified and experienced with US medical billing, coding, and denial management processes.
Scope of services
- Charge capture: Rendering medical services into billable charges.
- Claim submission: Submitting claims of billable fees to insurance companies.
- Coding: Properly coding diagnoses and procedures.
- Patient collections: Determining patient balances and collecting payments.
- Preregistration: Collecting preregistration information, such as insurance coverage, before a patient arrives for inpatient or outpatient procedures.
- Registration: Collecting subsequent patient information during registration to establish a medical record number and meet various regulatory, financial and clinical requirements.
- Remittance processing: Applying or rejecting payments through remittance processing.
- Third-party follow up: Collecting payments from third-party insurers.
- Utilization review: Examining the necessity of medical services.
- Our experience, investment in resources and knowledge of the industry make us the ideal partner for the growth journey of medical practices, clinics, and hospitals.
- We understand patient’s health information needs to be protected because we have achieved HIPAA compliance. Working with ACP makes you free of worries and anxieties.
- We turn deliveries around swiftly. We work through Standard Operating Procedures, which are tailored to the needs of each client, and hence, ACP delivers accurate results faster and consistently.
- We deliver quality. Claims submitted by ACP achieve 98% first-pass acceptance.
- We take pride in serving you. We appoint dedicated single-point-of contact for the complete range of services you subscribe to.