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Revenue Cycle Management Services in the USA - Prime Doc Billing

Revenue Cycle Management Services in the USA

Struggling to Maximize Revenue? Here’s How Prime Doc Billing’s RCM Services Can Help Your Practice Thrive!

Navigating the financial side of patient care has become very difficult in today’s fast-paced healthcare environment. Revenue Cycle Management (RCM) plays a vital role in maintaining financial stability, covering every stage from patient collection to the final payment.

At Prime Doc Billing, we take the complexity out of RCM. Our end-to-end Revenue Cycle Management (RCM) services are designed to boost revenue with faster reimbursements. We handle the financial legwork, optimizing every step of RCM while you can focus on patient care.

What Makes Our End-to-End Revenue Cycle Management Services Stand Out in the USA Market?

End-to-end RCM services refer to the financial process of managing every step. It begins when a patient is registered till the time a health care provider receives their deserved and accurate payment.

What Makes Our End-to-End Revenue Cycle Management Services Stand Out

Tailored Solutions

Prime Doc Billing offers more than just basic RCM services. We do not use a one-size-fits-all method; instead understand and tailor to the unique needs of different specialties.

Expertise Across Specialties

Our trained and certified experts have a deep understanding of different specialties like cardiology, orthopedics, psychiatry, psychology, neurology, and many more. We offer a customized plan of our RCM services that best fits the needs of a particular specialty.

Your Complete Guide to How Prime Doc Billing’s Revenue Cycle Management Services Work:

Revenue Cycle Management (RCM) is the financial heartbeat of health care organizations. From the scheduling of a patient to receiving the final payment, we will guide you to have a better understanding of how our RCM services work:

How Prime Doc Billing’s Revenue Cycle Management Services Work

Patient Registration & Eligibility Verification

Patient registration and eligibility verification mark the first step of RCM. At Prime Doc Billing, we verify demographics, insurance coverage, and out-of-pocket costs with precision to reduce denials. This is done before any services are provided to avoid risks and maximize revenue flow, all while enhancing the patient experience.

Medical Coding & Charge Entry

Medical coding involves translating the patient's treatment plan into alphanumeric codes. These codes are already set up by professionals. Here at Prime Doc Billing, we comply with three types of codes:

  • CPT (Current Procedural Terminology)- codes for medical services and procedures.
  • ICD (International Classification of Diseases)- codes for the diagnosis and conditions of a patient.
  • HCPCS (Healthcare Common Procedure Coding System)- codes for services not covered under CPT codes.

After successfully coding the patient’s detailed information, our experts at Prime Doc Billing in the USA identify the charges of treatments and procedures based on the coding of respective areas. It includes the fee schedule pre-set by the institution.

Claims Submission & Tracking

Our experts at Prime Doc Billing take care of this crucial step very smoothly. Claim submission is one of those steps that even an expert has to be mindful of. A single mistake can lead to great loss, but not on our watch. We streamline real-time claim submission data on EHR, which helps to reduce denials and increase revenue, boosting cash flow. We submit claims to insurance companies in an optimized way to save time and reduce errors. We use real-time tracking, which helps us detect any possible error that can lead to denial.

Payment Posting & Reconciliation

Our team at Prime Doc Billing uses the advanced digital resource Electronic Remittance Advice (ERA) which helps us get a proper record of payments made by patients or insurance companies. By the use of ERA, our experts can get proper reconciliation. Reconciliation refers to matching the payment posted and the bank statements to ensure the right payments are made. We record those payments to keep track of whether the insurance is paying the right amount to the health care providers.

Denial Management & AR Follow-up

Our experts at Prime Doc Billing use a comprehensive strategy to identify, analyze, and resolve the issues that lead to denial management. We make sure to provide our clients with proper reimbursement because every dollar counts. Prime Doc Billing consistently follows up on the Accounts Receivables Aging Report to determine how long payments have been outstanding. Our team maintains regular communication with the insurance agencies to identify and resolve potential issues, thus ensuring cash flow. Our result-oriented approach is what makes us one of the top medical billing service companies in the USA.

Patient Billing & Collections

We verify the patient’s insurance beforehand and get an estimate of what they will owe. Our team encourages up-front payment to keep the revenue cycle moving. After that, we provide an easy-to-read bill to the patients for outstanding balances determined by aging reports, along with friendly reminders and payment plans if needed. We believe in compassionate collection while being respectful to our clients. Our payment plans have always proved to be beneficial, and we continue to improve them for our clients.

Reporting & Analytics

Our team keeps a report of every possible angle to stay financially healthy.

  • Claims that were accepted at the first try
  • Identifying claims that were denied
  • How long have the payments been outstanding?
  • Amount collected vs. amount pending
  • Insurance company performance

Keeping a report of the following, analyzing the metrics, fixing the bugs, and constantly finding ways to improve the revenue cycle can help generate a better cash flow.

Compliance & Audit

Here at Prime Doc Billing, we comply with the rules set by HIPAA (Health Insurance Portability and Accountability Act). Our client’s Protected Health Information (PHI) stays safe within our system. We use technical and administrative safeguards to control who can get access to the patient’s information. Our experts conduct a brief and thorough audit regularly to assess the compliance and accuracy of the records. We monitor billing practices, coding accuracy, and adherence to ethical requirements.

Outsource RCM To Prime Doc Billing And Say Goodbye To Billing Errors:

Outsource RCM To Prime Doc Billing

Prime Doc Billing has a team of certified coders from the American Association of Professional Coders (AAPC), a Quality Assurance (QA) team, Virtual Assistants (VAs), and, Accounts Receivables (AR) team, who have years of experience in this industry. Every member of our team works collectively to produce the best outcomes of benefits for our clients. Some of them are:

Improved RCM

Faster reimbursement rates

Real-time reporting and transparency

Enhanced patient satisfaction

Reduction in denials

Access to advanced billing technology

Ensured billing compliance

Free Practice Assessment:

Free Practice Assessment

Prime Doc Billing offers a free initial practice assessment. We provide our clients with a comprehensive report covering coding, billing, and AR analysis. The report helps identify key gaps and opportunities for optimization in the revenue cycle.

How Can An Effective RCM Workflow Improve Your Practice’s Bottom Line?

Effective RCM Workflow

Our trained experts at Prime Doc Billing keep enhancing the RCM process for a better workflow. This also helps to align with the updated and best practices of this industry. We go through the following key stages of the RCM workflow with the help of a cloud-based medical billing software:

Discovery & Assessment

We gather all the existing data to have a complete understanding of key gaps and weak points. Those weak points can either be incorrect patient data, insurance verification problems, coding errors, or a lack of proper follow-up. After identifying the underlying issues, we work towards an action plan for a target solution for better revenue optimization.

Onboarding & Integration

Our team can get on board with your revenue cycle with a smooth transition. We integrate seamlessly with your policies and culture as if we were already a part of your team.

Process Implementation

Going completely by the book and following standard procedures is not always practical in real life. We understand the individuality of every revenue cycle, thus implementing the strategies accordingly.

Ongoing Monitoring

We monitor every step of the way to understand the metrics through detailed reports. This helps us keep track of and make improvements in real-time.

Continuous Improvement

With the unstoppable advancements in the medical billing industry, we continue to grow. We adapt, implement, and improve every new day to provide better results to our clients.

Top Benefits of Partnering with Prime Doc Billing for Revenue Cycle Success

Benefits of Partnering with Prime Doc Billing for Revenue Cycle Success

With the advanced software, technology, and up-to-date training of our experts, Prime Doc Billing provides several benefits in our RCM services:

Faster reimbursements

Access to the latest industry regulations and experienced professionals

Quality of care

Dedicated POC for effective communication and correspondence

Increased efficiency

HIPAA Compliant

Data integrity

Improved cash flow

Simplified processes

Error reduction

Financial stability

Minimized claim denials

How Do I Sign Up For RCM Services At Prime Doc Billing?

Prime Doc Billing offers the best medical billing expertise in the US. You can focus solely on your treatment while leaving the rest to us. Our services are available all over the US with virtual assistants. You can also book a demo on our website to get an idea beforehand.

Frequently Asked Questions

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