Revenue Cycle Management Services

An Emergency Room/Department is one of the most fast-paced departments in any hospital or a clinic. When a patient comes to the ER in a critical condition, eg an accident, heart attack, organ failure, etc, the insurance and the reimbursements should be the least of the worries for the patients and the hospitals. The level of care and treatment needed for these patients needs to be of the highest level.

Medical billing and coding are integral, yet complex services of a medical provider’s revenue cycle. The medical billing and its coding are a closely related function, which ensures prompt reimbursements to the healthcare provider for the services he renders. The medical practice has to concentrate on various aspects while implementing billing and coding that takes away the focus from its core function of treating patients. That is when outsourcing the billing and coding services to Atlantic RCM becomes a viable option.

Insurance eligibility verification is the first and the most integral step in the medical billing and coding process. Studies indicate that most denials occur due to inadequate and unclear insurance coverage information. This in turn directly impacts the revenue flow for the healthcare firm. Hence, insurance eligibility verification becomes an indispensable process that requires the services of professional industry experts.

Accounts Receivable Management service is a key Revenue Cycle Management function for every hospital and healthcare provider and crucial for the stability and financial success of the medical practice. The main aspect of managing A/R recovery is to make sure the claims get paid and the patients pay the charges that are due. The survey states that as much as 25% of the patient services are unpaid and around 40% of claims are denied or not resubmitted, leading to a huge loss to the healthcare provider.

Healthcare is continually changing that makes maintaining fiscal stability challenging for physicians and medical practices. The medical provider needs a successful revenue cycle management approach that focuses on providing end-to-end medical billing services to deliver smooth and seamless revenue payments.

Denial management is a critical component for any healthcare provider, independent physician, or medical practice. Denial claims represent unpaid or delayed revenues to your practice. Failure to adequately handle denials translates to lost revenues for your practice. A healthcare practice employs a substantial amount of resources to have an efficient revenue cycle management system.

Physician credentialing is gaining importance lately as it is one procedure that helps the patients build their trust in their healthcare providers. Credentialing ensures the healthcare providers are qualified, having a proper license, and certifications. Physician credentialing involves a standardized process of organizing and verifying the doctors’ professional records such as education and hospital privileges.