RCM Services
Efficient and effective Revenue Cycle Management (RCM) is integral to quality medical care. PRS specializes in comprehensive RCM services, offering end-to-end medical solutions aimed at maximizing revenue and profits. The intricate administrative demands within medical facilities such as hospitals, clinics, or laboratories often overwhelm existing staff, leading to profit reductions. Amidst the complexities of medical protocols, errors can occur, including incorrect patient information during registration, lack of adherence to proper medical documentation, or discrepancies in IDs — these issues become costly when insurance claims are rejected. Therefore, having an RCM service guiding from patient registration to discharge is of paramount importance.
Our well-trained staff, auditors, and coders ensure every dollar is efficiently earned through robust processes, up-to-date knowledge of industry standards, adaptation to evolving medical trends, and leveraging Information Technology to minimize errors. Employing software solutions, we strive for high levels of automation capable of managing tasks from patient registration to analyzing insurance denials and Accounts Receivables (ARs).
We initiate our diverse range of services from scheduling appointments, optimizing them, consequently alleviating the burden on in-house medical staff. Our expert team assesses medical insurance matters, clarifying aspects like Eligibility, Coverage benefits, Copay, Deductibles, Co-insurance, OOP, Contract rate, LTM, Pre-existing, Stop loss, COB, Patient liability, Self-pay thereby preventing claim denials. Our certified coders and auditors are well-versed in every standard of medical documentation, such as COC, CIC, CPC, CPC-P, CPC-O, and CPC-H. Precise coding is meticulously crafted to reduce claim rejections and enhance Accounts Receivables (AR). We maintain consistent follow-ups on pending insurance claims and account receivables in a cyclic manner to enhance profit margins.
At PRS, we employ Data Analytics to delve into topics such as demographics, the quality of Medicare services, claim acceptance/denial, and reporting. Our expert team delves deeply into the demographics of claims to discern their sources. We meticulously scrutinize and conduct relevant Root Cause Analysis (RCA) on rejected or denied claims that could impact the business — dedicated teams work in a time-bound manner to address these issues. A comprehensive report is furnished, encompassing details of rejected/accepted claims, financial statements, demographic information, and more. This initiative is aimed at educating and empowering our staff to optimize client service.
The profitability of your Medicare enterprise is of utmost importance to us. Hence, we assign managers and experts to handle various accounts in a customized manner, providing seamless 24/7 support.
Opt PRS RCM Services to:
1) Attain the highest standard of clean claims
2) Collaborate with top-tier medical coders and auditors in the industry
3) Receive the utmost accuracy in billing and medical coding
4) Consistently enhance profit margins and revenues through quality assessment
5) Access detailed reports containing authentic finance and productivity data
6) Ensure the security and confidentiality of your business data
7) Benefit from cyclical follow-ups on insurance claims and account receivables