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Revenue Cycle Management

We provide physician practices in the USA with Revenue Cycle Management (RCM) services. In the healthcare sector, RCM is a popular term.

What is Revenue Cycle Management?

Revenue cycle management (RCM) is how healthcare organisations bill for their services. The process begins when the patients schedule their appointment and ends with the final payment made. It involves tracking all the services provided, transcribing them, translating them into standardised codes, and using these codes to fill out claims to be sent to payers. While most payments come from insurance payers, some also come from patients.

What is RCM Workflow?

The revenue cycle management workflow comprises all the steps involved in billing and payment collection for medical services rendered to patients. They are

Patient scheduling

Managing patient appointments is only one aspect of efficient patient scheduling. To increase collections, it is essential to effectively gather patient information for eligibility checks, prior authorization requests, and upfront patient responsibility determinations.

Why you need remote Eligibility and Benefits Verification

Verifying eligibility helps healthcare providers submit accurate claims. By minimising claim resubmission, it decreases eligibility-related rejections and denials in RCM, boosts collections, and enhances provider satisfaction. We do ensure that there are not eligibility related issues when patients visit the clinic by verifying patients in advance.

  1. You can stop thousands in visit losses at a fair rate with a straightforward remote conversation.
  2. By making sure you can actually get paid, you may improve your billing accuracy and payment schedules.
  3. Avoid patients' complaints and grievances for showing up to visits and procedures you perform.

Patient pre-authorization

In the context of medical billing, authorization refers to the process through which the payer grants permission to pay for the required services before they are actually provided. This is often referred to as prior authorization services or authorization.

Medical coding

Medical coding converts information from doctors into widely used, internationally regulated medical alphanumeric codes. For the purpose of creating claims that are delivered to payers for reimbursement to providers, coding summaries of all medical services rendered to patients. Prescriptions, doctor's notes, radiological scans, and laboratory tests all have codes. Clinical visits for each patient are recorded and then assigned codes.

Charge posting

Based on the charges entered, the provider will be paid for the services provided. Expedite and increase your accuracy with the first step of the revenue cycle process.

Claim Submission

In accordance with your payers and clearinghouses, we generate bulk electronic claims.

Claims scrubbing

Claim scrubbing is the process of finding and fixing coding errors before medical practices submit medical claims to insurers. Claim scrubbers manually check the information on medical claims before submitting them to payers.

Payment Posting

Ensure your ledgers are accurate by accurately recording all payments, fees, and refunds.

Denials and Appeals management

In case of denials from payers, the provider will analyse the claim and the reason for the denial and take necessary steps to get paid for those claims. Now, we all know that providers don’t have much time to go through each and every rejected or denied claims. So, we at AYS Medical Billing Services make sure that providers don't have to suffer because of this complex process of getting claims paid by working efficiently and by making appeals on behalf of them.

Accounts Receivable

The outstanding invoices or the money that a facility or hospital has yet to receive from the insurance companies or patient are accounted for as accounts receivable. Sometimes, payers and customers do not obey the company’s payment terms and delay their invoice payments. This requires the AYS accounting team to spend additional time and effort following up with them in order to reduce the additional trouble and outsource their accounts receivable management procedure. AYS saves business time and cost and helps them stay on top by enabling them to mark receivables as paid instantly.

Patient Statement

Patient statements are medical bills that help the health care providers collect the medical fees from patients more efficiently and with lower administration. When we say lower administration, we mean that AYS will take care of those medical invoices by sending them to the patients via mail or electronically on behalf of providers.

24/7 End-to-End billing management services. Lets Physicians Focus on Patients.

Why it is important to take and choose AYS Medical Billing.

Healthcare in the United States is complicated. It involves an elaborate series of steps, from the patient’s clinical visit to the final payment. A dedicated process or management for revenue cycle management (RCM) by AYS Medical Billing will ensure that all the steps are carried out smoothly without any problems.

AYS Medical Billing Services ensures that providers can get paid on time without delays or hassles. This will enable them to remain financially feasible and be caring towards their patients.

One of the biggest advantages of Choosing AYS Medical Billing is the reduction in operating costs for providers. In the absence of such solutions, providers would need to hire a certain number of people to handle the billing and financial part of healthcare operations. But AYS can build revenue for consolidating these activities and enable a smaller staff to do what would otherwise have needed more people. By doing so, we help providers from spending their hard earned money on excessive space and staff.