Revenue Cycle Management (RCM) is the financial process that medical practices use to track patient care episodes from scheduling to final balance payment. This is all done with the aid of medical billing software. This software is an all-in-one system that tracks patient payments, aids in collecting payments, works with insurance companies and takes care of claims processing. Our healthcare software solutions work to get you the same return you would receive from a point of service transaction.
As a physician, you want to be sure that your practice is on top of the revenue cycle process. We can help by implementing proper coding, effective patient registration, insurance eligibility, charge capture and more. If you have any doubts about whether you’re achieving the best results from your accounts receivable management, think about how much revenue growth you could see from professional assistance. We can help you collect payments quickly, lower your adjustments/write-offs, and reduce your claims denial rate on first submission. Why continue with an outdated system when your competitors are already using revenue cycle management?
Before we get into the logistics behind our healthcare software solutions, let’s go over what the revenue cycle entails. This will help you get a better understanding of how our technology can automate tedious, time-consuming RCM medical billing processes.
Charge capture: In this step, medical services are translated into billable charges.
Claim submission: Claims with billable fees are sent to insurance companies.
Coding: Diagnoses and procedures are assigned the appropriate code.
Patient collections: Patient balance is calculated based on outstanding balances after insurance is applied. Payments are then collected.
Preregistration: Preregistration information is gathered from the patient prior to their arrival at your practice. This info includes insurance coverage.
Registration: Subsequent patient info is collected during registration to create a medical record number. This step also ensures the patient meets regulatory, financial and clinical requirements.
Remittance processing: In this stage, payments are either applied or rejected.
With each cycle, your chances for error increase. These errors inconvenience your patients and prevent you from bringing in revenue for your practice. The extensive expertise and labor needed to carry out the process efficiently make software automation worth the cost. Revenue cycle management is the best way to ensure you get paid on time.
We’ve found that the biggest challenge physicians face with their revenue cycle is collecting payments from patients with high deductibles. In fact, 83% of physician practices with five or fewer physicians reported this as their biggest hurdle. Physicians are turning to technology to help them overcome commercial payers that scrutinize claims now more than ever before. That’s where Pulse Revenue Cycle Management comes in. Our systems allows healthcare organizations to focus on delivering high-quality service to their patients while we focus on the financial health of your practice.
A Midwest Orthopedic practice using Pulse Revenue Cycle Management is in the top 10% of their specialty. They have a 98.7% clean claims submission rate on the first pass. This is made possible by our health system’s ability to decipher ICD-10 codes accurately and quickly. Pulse handles all the follow-up on any claims that are denied or need to be reworked. Practices have realized an increase in their charges, a significant increase in receipts and fewer days in A/R. Management systems make the payment cycle flow smoothly.
Pulse’s Revenue Cycle Management uses comprehensive claims scrubbing rules. This means Pulse clients receive optimal billing rates and first time claim acceptance rates that average over 98%. Pulse Revenue Cycle Management clients benefit from higher collection rates, shorter payment cycles and reduced operation expenses. Our results are measured against, and often exceed, MGMA best-practice benchmarks. If you’re still not convinced, read our report on 10 reasons to outsource RCM.
There are no start-up costs, no software licensing fees, no hardware or server investments and no ongoing maintenance or software upgrade fees. The Pulse Revenue Cycle Management cost-sharing model aligns with the success of the practice. Pulse Revenue Cycle Management has been delivering results for more than two decades. We continuously strive for improvement through an ongoing process of measuring results, streamlining processes and developing advanced automation tools. We want you to feel comfortable with your new system too, which is we offer an RCM resource center to outline the benefits of our system and ways you can optimize a system that’s already in place.
The flow of payments between interested parties consists of a vast network of payers and payees. Even more complex is the relationship between the various parties involved. This complexity requires constant maintenance and management to ensure you receive payments in a timely manner to maximize payments received. Failure to recognize these complex rules often results in inaccurate claims denials. Finally, failure to comply with payer rules can result in legal liability for those responsible for billing and collection. Historically, compliance with payer rules was dependent on either the ability of the billing and collection specialist or the technology available to them.
Pulse puts the best people on the frontlines to work for you. We increase your collections and meet your reimbursement goals. In a 2016 independent study on Revenue Cycle Management services, Pulse ranked #1 across the industry for small practices. Our team of certified coders and billing specialists go above & beyond for our clients. We provide weekly and monthly reporting of our results based on your needs. Along with RCM services, our clients have access to our certified practice management and electronic health record solutions: all for a small percentage of what they collect.
Let’s face it, your practice is busy! With the constant churning of the healthcare landscape, it’s only getting busier. Partner with a medical revenue service company who’s been in the industry for 20 years and provides rapid deployment with the best quality solutions. Pulse Revenue Cycle Management includes:
Pulse Revenue Cycle Management supports your practice’s financial functions with certified coders and collections experts. Pulse Revenue Cycle Management is the perfect solution for physician practices that want to focus on delivering healthcare to their patients.
Because Pulse Revenue Cycle Management uses comprehensive claims scrubbing rules, our clients receive optimal billing rates and first time claim acceptance rates that average over 98%. Pulse Revenue Cycle Management Services consistently deliver higher collection rates, shorter payment cycles and reduced operating expenses.
Simply put, healthcare revenue cycle management helps healthcare providers by collecting more money! PulseRCM customers realize an increase in their charges, a significant increase in receipts and fewer days in A/R — shorter payment cycles mean more money, faster! You can make the process even more efficient by implementing these 4 ways to achieve next-level revenue cycle performance.
Find out why practices have used Pulse for more than 20 years.
We offer an intuitive system that works for you with a dedicated support team that knows you by name. That’s the Pulse difference.
Identify revenue cycle managment problems with this 10 point assessement (Free, No Risk) worth over $3,500.