Hospital RCM Services
Promantra has a robust team encompasses highly skilled certified resources in Revenue Cycle Management domain. We have people with over 8 years of experience heading the operations and the average team's experience is 4 years.
Our comprehensive solutions provide better compliance at lower costs, enabling our clients to focus on their core business that is, providing better health care. We have all the capabilities that can improve and accelerate you revenue cycle process, so you can achieve higher productivity, faster payments, decreased costs, and improved patient service.
Each team member has substantial experience in the U.S. healthcare industry to analyze Explanations of Benefits (EOB's) and claims, and take the necessary actions to recover the due amount. We will reduce days in account receivable, improve collection ratio, and increase the probability of payment.
Below is the staged representation of our End to End Revenue Cycle Management Services.
Revenue Cycle Management Services
Patient Demographics Entry: Capturing patient's name, address, SSN, Employer and Insurance Information.
Insurance Eligibility Verification: Insurance information obtained during admit /registration process is verified with the Insurance/third party carriers.
Charge Entry: Charge entry is carried by gathering all charge documents from all departments, within the facility that have provided services to patients.
Coding: All documents are reviewed for the services provided and appropriate ICD-9-CM are assigned, also CPT-4 codes as applicable are assigned.
Claims Processing or Billing: Gathering claim information and generating appropriate claim form. Claims are processed electronically or manually to insurance carriers with the information necessary for reimbursement.
Patient Billing: After final payment has been made by the insurance carries, the accounts are assigned to representatives, to invoice patients, and notify the patients with follow up reminders, of their responsibility to pay and arrangements made for payment.
Collections: When patient payment is not received in a timely manner, collection activity on the balance of the patient account will begin.
Payment Postings: When payments are received, the appropriate payments and insurance carriers are posted to the patient accounts along with any patient payments until the balance has been satisfied.
Denial Management: The difference between facility charge an payment received is obtained through the EOB, Explanation of Benefits received from the insurance/third part carriers. Determination of whether appropriate reimbursement has been made, and if not, an appeal, a formal request for re-consideration is made.
