Full Revenue Cycle Management Consultation

Service Description

Services Included in the Package: A standard, full-service RCM package covers the complete lifecycle of a medical claim, divided into two distinct phases: Mid-Cycle (Claim Preparation) and Back-End (Collections & Compliance). 1. **Mid-Cycle (Claim Preparation)**: - Eligibility Verification: Insurance verification prior to claim submission. - Medical Coding: Abstracting clinical notes and applying correct ICD-10, CPT, and HCPCS codes. - Charge Capture: Entering the codes and financial details into the billing software. 2. **Back-End (Collections & Compliance)**: - Claim Scrubbing & Submission: Electronic clearinghouse checks to ensure error-free submissions. - Denial Management: Appealing and correcting any claims rejected by insurance payers. - Patient Billing: Sending statements for patient co-pays, deductibles, and handling patient collection calls. - Account Receivable (A/R) Follow-Up: Actively tracking down aging unpaid claims (30, 60, 90+ days). - Monthly Compliance Audits: Regular internal chart checks to protect the practice against federal audit risks.