Handling complete practice revenue management, from claim creation to claim submission, A/R follow-up, denials management, payment posting, clearinghouse rejections, enrollment & credentialing, financial analysis, Audits, HIPAA compliance, and any relevant task.

RCM Manager Complete Practice Management System

• Patient Registration & Verification
• Coding & Documentation
• Claim Submission
• Claim Adjudication
• Payment
• Explanation of Benefits
• Patient Responsibility
• Appeals & Resubmission
• Record-Keeping and Compliance

AR Follow-up Services

• Review Aging Reports
• Contact Insurance Payers
• Resubmit Claims
• Follow Up with Patients
• Appeals
• Utilize Clearinghouses
• Escalate as Needed
• Regularly Recheck AR

Analyze Trends

Provider-Payer Communication

Verification of Benefits (VOB)

• Effective date of the insurance policy.
• The type of coverage (e.g., PPO, HMO, Medicare, Medicaid).
• Services covered (e.g., hospitalization, surgeries, outpatient care).
• Pre-authorization requirements
• Deductibles and out-of-pocket maximums
• Copayments or coinsurance
• Coverage limits or exclusions
• Referrals or pre-certifications

Reporting and Analytics

• Aging Reports
• Claim Status Reports
• Denial Reports
• Payment Reports
• A/R (Accounts Receivable) Reports
• Productivity Reports
• Referral Reports
• Provider Performance Reports:
• Compliance Reports
• Payer Analysis Reports
• Patient Financial Reports
• Monthly Payment Reports

Year-End Financial Reports