Revenue Analysis

Revenue cycle management (RCM) is overseeing the billing process, payments, and revenue charting. Properly managing the processes of revenue cycling is a health care organization’s financial backbone and the strength needed to be successful. RCM is comprised of all facility operations including administrative (front-end eligibility process and back-end collections), clinical functions and proper billing and coding. Managing this process successfully is essential in order to capture and manage potential concerns and risks in an organization’s current processes. Revenue analysis is a complex and continuously evolving due to the ever- changing guidelines surrounding the health care industry, especially within the substance abuse and behavioral health community. Our team identity gaps in a facility’s current billing and collections process and create a solution with immediate action. Our process is to track revenue with the use of advanced technology in order to examine a facility’s entire AR lifecycle to maximize financial growth. We research whether payments are collected accurately and address any denied claims of unresolved billing issues. Revenue cycles are a specific area of an organization that is consistently experiencing change. We create a system that effectively prevents the denial of claims from becoming timely. 

WE OFFER THE FOLLOWING:

• Scheduling and Completing Administrative / Insurance Documentations

• Utilization Review and Case Management

• Clinical Documentation

• Charge Entry and Coding

• Claim Submissions

• AR Follow-Up

• Tracking and Working Denials

• Report Accurate Payment Posting, Appeals, and Collections

This process starts from the very beginning to ensure that there are little to no gaps. Understanding the key components of RCM will allow providers thoroughly and continuously examine any concerns, risks, and gaps in their revenue chain and improve efficiency. RCM is effective in producing accountability and maximizing revenue.