Revenue cycle management (RCM) is the financial process used by healthcare institutions to track patient care episodes from registration and appointment scheduling to final payment of a balance using medical billing software. It is a normal part of health administration. The revenue cycle can be defined as, "all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. It is a cycle that describes and explains the life cycle of a patient (and subsequent revenue and payments) through a typical healthcare encounter from admission (registration) to final payment (or adjustment off of accounts receivables)
Revenue cycle management solutions provided by MF
By enrolling in our revenue cycle management program, MF assures you of the quality services returns to your choice. From confirming a patient's insurance coverage, hospital admission, treatment, and discharge, to post-discharge claims and account settlement, we can manage the complete revenue cycle.
MF Experience in revenue cycle management
The revenue cycle includes all the administrative and clinical functions that contribute to the capture, management and collection of patient service revenue, according to the Healthcare Financial Management Association (HFMA).
Here is a quick summary of our revenue cycle management methodology:
verifying insurance coverage and benefits
After patient scheduling verifying patient benefits is important for the healthcare provider to understand limits and possible reimbursement payment from insurance carrier as per patient plan.
Pre service appeal
In some case when the authorization denied due to medical necessity so planned the service which is not performed can be appealed for peer2peer discussion. d. This process is to discuss the case and will not reverse the original determination.
Clinical documentation
Clinical documentation (CD) is a record detailing a medical treatment, medical trial, or clinical test. These records consist of accurate, timely, specific diagnoses, and procedures that are translated into coded data to represent a patient's clinical status.
Medical transcription and coding of patient health information and management
Properly converting the medical records into payable insurance codes is important following the CMS guidelines for reimbursement.
Charge capture and claims entry
Entering the medical codes, patient information, provider information and insurance information using the billing system and generate the claim and submitting to insurance in timely manner.
Payment posting and denial management
Posting the payment received from insurance carrier/patient to the respective patient case corresponding to claim line items in billing system. Also posting the denial reason if any to the claim and sketching an action plan for the denial
Review of non-payment causes and corrective actions taken to increase revenue realization
Follow up and collection efforts for unpaid claims
Regularly making follow on the delinquent claims and working accordingly to AR aging claims
Patient case management
Post service appeal
A Post-Service Appeal is an appeal made subsequent to the performance or issuance of the services.
MF has a combined 50 years of experience in RCM; we have managed multi-specialty billing cycles and have first-hand working knowledge of all RCM divisions Partnering with our outsourcing program entitles you to complete outsourcing satisfaction.
You reduce your operating expenses by roughly 60%.
All day, every day Providing services around-the-clock to ensure timely turnaround
Your revenue cycle management will be taken care of by knowledgeable staff.
A committed team for each client
Continuity of operations management that is guaranteed
Proactive follow-up on delinquent claims for consistent revenue collection
Proven methods that are HIPAA and PHI compliant for high-performance revenue cycles
Risk-free outsourcing that adheres to data security regulations
You require a solid outsourcing partner who can assist you in meeting the demands of the healthcare business. MF has a track record of successful projects and satisfied clients. You can trust MF's expertise, specifically our skill in managing healthcare revenue cycle services. We guarantee that your outsourcing relationship with us will be productive and effective.
Send us an inquiry if you're interested in outsourcing medical billing, medical coding, insurance follow up, denial management or RCM to Mayflower, and we'll respond with the best possible solution.
