Comprehensive Revenue Cycle Management Solutions for Optimal Financial Performance
At NextGen Consultancy, we offer state-of-the-art Revenue Cycle Management (RCM) services designed to streamline your practice's financial operations. Our team of experts leverages the latest tools and technologies, including Office Ally, to ensure your claims are processed efficiently and your revenue is maximized.
- Efficient claim processing
- Comprehensive reporting and analytics
- Seamless integration with EHR systems
- Patient eligibility and benefits verification
Revenue Cycle Management
EXPERT GUIDANCE AND ASSISTANCE FOR YOUR REVENUE CYCLE MANAGEMENT NEEDS
Error-Free Charge Entry
We ensure accurate and prompt charge entry for all claims. Our billers capture and input all necessary patient demographics and charge information for flawless claim processing.
Medical Coding
Our expert coders assign up-to-date CPT, ICD-10, and HCPCS codes, along with NCCI edits, ensuring precise coding for accurate reimbursement and a smooth audit process.
Claim Scrubbing & Submission
We meticulously scrub and submit all claims to ensure they are clean and error-free. Rejected claims are resubmitted promptly after corrections, whether electronic or paper.
Real-Time Insurance Verification
We verify each patient's insurance eligibility in real-time, reducing receivables and preventing denials, making your process more efficient.
Payment Posting
Our team posts ERAs and EOBs promptly and accurately, ensuring all payments are correctly applied to patient accounts.
Patient Statements
We generate detailed patient statements after confirming payments from all payers, ensuring patients are aware of their balances.
Follow Up & Appeals
Our A/R specialists handle denied claims by identifying the cause, resolving the issue, and processing the due payments.
Denials & Appeal Management
We track and resolve denied claims, aiming to improve your clean claims rate and reduce future denials through timely appeals.
OUR REVENUE CYCLE MANAGEMENT PROCESS
Our RCM Process to Prevent Revenue Loss and Minimize A/R Aging Cycles
Patient Registration
- Accurate patient data collection including demographics, medical history, and insurance details.
- Verification of patient details to ensure completeness and prevent errors in subsequent steps.
- Maintaining updated and secure patient records for future reference and continuity of care.
Prior Authorization & Eligibility Verification
- Obtaining prior authorization from insurance companies for specific treatments or procedures.
- Ensuring patients meet eligibility criteria to avoid coverage issues and claim denials.
- Efficient charge posting to expedite reimbursements and minimize delays.
Medical Coding
- Applying accurate, error-free standardized coding to all medical records and procedures.
- Identifying and rectifying any coding errors promptly to prevent billing issues.
- Ensuring compliance with the latest coding standards and regulations.
Charge Entry
- Promptly entering patient charges into the billing system to ensure timely billing.
- Capturing all services rendered accurately to prevent revenue loss.
- Verifying charge entries against clinical documentation to ensure accuracy and completeness.
Claims Submission
- Submitting claims electronically to insurance providers for faster processing.
- Ensuring claims are clean and error-free to reduce the likelihood of denials.
- Maintaining accuracy and adherence to industry-standard protocols during submission.
Denial Management
- Constantly following up on the status of submitted claims to identify any issues.
- Addressing old claims, rejections, denials, and delays promptly to recover revenue.
- Minimizing A/R aging cycles to improve collections and maintain cash flow.
Payment Posting
- Posting payments accurately after successful claims processing, including co-pays, deductibles, and insurance payments.
- Ensuring financial transparency and correctness in patient account balances.
- Reconciling payments with Explanation of Benefits (EOBs) to ensure accuracy.
Medical Billing Audit
- Conducting regular billing audits to identify discrepancies in submission patterns.
- Thoroughly tracking all steps to improve the potential Revenue Cycle Management (RCM).
- Implementing corrective actions based on audit findings to enhance overall billing efficiency.
MAJOR INSURANCE PROVIDERS
Clearing Claims With Major Insurance Providers
We efficiently handle claims with a wide range of insurance providers. Our expertise ensures timely processing and improved reimbursement rates, allowing you to focus on patient care while we manage the administrative details.
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Helping Healthcare Businesses All Around America.
We’re here to help healthcare businesses across the United States achieve their goals. Whether you have questions about our services, need support, or are ready to take your practice to the next level, our team is ready to assist you.