Keep yourself independent and profitable:
RCM Brain can show you how to collect more and spend less.
Beth joins your existing billing team to make them a lot happier and a lot more productive.
Unlock your growth by:
Reducing Insurance Revenue Leakage
Ensuring Payment Accuracy
Improving Staff Productivity and Morale
We used to struggle to make payroll when payers would change the rules and our AR would build up. Now I can focus on our strategic goals without worrying about revenue leakage.Chief Financial Officer
Recruiting and keeping good staff has been a challenge for years. Now that I can keep things running smoothly I can focus on keeping the best staff and investing in leadership training.Chief Operations Officer
I don’t have to worry about getting my vendors to integrate with each other. RCM Brain gives me scalability and interoperability that I have never had before.Chief Technology Officer
revenue leakage as the cost of doing business.
Reduce Insurance Revenue Leakage
For any one patient, several team members must complete a series of tasks from helping your patient check-in all the way to coding, creating, and submitting a claim for billing.
Unfortunately, there’s a lot of opportunity for errors in the claim processing chain. And if those errors aren’t resolved before your claim is submitted, the payer may:
- Deny the claim outright
- Request additional information
- Pend the claim for various technical reasons
- Not respond at all
On average, about half of all claims don’t get paid within 30 days and often require some type of follow up from the accounts receivable team. In other words, your team is spending a tremendous amount of time preparing, submitting, re-evaluating, and re-submitting claims, all of which translates to revenue leakage for your company.
But if you enlist Beth and the revenue cycle experts at RCM Brain, we’ll monitor your claims from the time an appointment is made to when you receive payment from the payer. If a claim is:
- Denied – Beth will determine why, reprocess the claim, and use that information to better file similar claims in the future
- Improperly Paid – Beth will follow up with the payer or, for more complicated cases, prompt a member of your accounts receivable team to follow up
- Ignored – Beth will follow-up with the payer to get a response
Beth will dramatically reduce insurance revenue leakage while eliminating up to 80% of the claim processing, billing, and collection workflow.
Take the mystery out of the payment process.
Beth will monitor the payments your practice receives so your team won’t have to double-check contracts in an attempt to determine whether or not payers are following the most up-to-date contracts.
Improve Payment Accuracy
Ensuring payment accuracy is a challenging feat for providers of every size. The amount that gets paid for each individual charge on a claim, from each different payer, for each different plan can vary dramatically.
On top of all that, the amount actually paid out by each payer may not line up with what your practice should receive based on contracts and fee schedules.
Because there is no way to guarantee payment accuracy, the average provider is underpaid by as much as 11% by insurance companies.
But when Beth and RCM Brain join your team, we’ll:
- Reverse engineer the fee schedule and payer contracts based on your historical payment records
- Audit those historical payments against actual fee schedules and contracts that exist to identify past underpayments
- Going forward, proactively catch underpayments as they come in
can help your current staff work smarter?
Improve Staff Productivity and Morale
Because your back office staffers have to navigate the complex system of filing, submitting, and billing claims, team members typically require up to six months of training before they can operate at full capacity. Due in part to the tedious nature of the job, there’s also a very high turnover rate. In many cases, employees only stick around for one to three years.
But by making Beth a long-term addition to your staff, team members will shift their focus from paperwork to the aspect of their job they actually enjoy – helping patients. In the process, you could dramatically boost morale and productivity at your company.
Instead of your team members calling payers for just about every claim, Beth will automate the tedious, mundane, but necessary tasks that keep your office running smoothly.
Beth can work across your office’s different systems and manage the minute details in claims processing and billing.
clean up old AR and automate your billing.
To simplify the process, let Beth mediate.
Simplify Order Submissions
Your company gets more and more orders every day. What’s not to like? Well, because you and your team have to sift through a complex mix of providers to fulfill orders, these requests can sometimes feel like an onslaught.
Your team deals with a barrage of inconsistencies because your clients are spread across the United States and around the world and use a variety of methodologies when submitting orders.
Beth can sort through your clients’ order submissions faster and easier than your team can manually. She’ll also increase client satisfaction by verifying that your orders are complete and accurate.
starting to worry you’ve got too much of a good thing,
contact the team at RCM Brain to hear how Beth can help you.
Ensure Consistent Documentation
When referring providers or hospitals place orders, the documents required to receive payment aren’t always submitted along with the claim because that information:
- Could still be in authorizations
- Have an authorization request pending
- May not fully account for the authorized services
- Has not been approved by the provider placing the order and/or the insurance payer
Currently, your team has to perform a tremendous amount of AR follow up to gather that documentation after the claim has already been submitted. And, unfortunately, this often results in your company failing to capture and gather the necessary information.
But if you get Beth to oversee this process, she’ll guarantee every order received will also incorporate:
- A request for supporting documentation
- A check of payer pre-authorization
- Free up your staff to complete other tasks
Beth ensures the information need to receive payment is already on file before services are rendered.
making sure you receive proper documentation for each order.
Identify Errors Before Submission
Due in part to the diverse array of services and equipment being billed, there are a lot of ways insurance companies can deny a claim for technical reasons.
If these errors are caught before submission, your company can prevent the vast majority of technical denials. Achieving such a feat is easier said than done when dealing with a high volume of claims.
Instead of tasking your team with the tedious, time-consuming, and all but impossible task of verifying every detail in every submission is correct, allow Beth to take over. She’ll dramatically reduce the amount of errors before submission by scrubbing every claim and tying it back to the originating order and all necessary supporting documentation.
needed and provide them before their requested.
Submit Additional Documentation
Claims that require follow up in the form of supporting documentation often go unpaid. And you’ve likely found that payers are increasingly asking for supporting documents.
Inevitably, a variety of challenges for your company crop up because these additional documents cannot be submitted electronically or at the time of claim submission. Consequently, your company leaks a large amount of revenue because required documents are:
- Not being submitted
- Being submitted in a very time-consuming and tedious way
Stop wasting time and money and hand off these tasks to Beth. After each claim has been submitted, she can:
- Collect and submit additional documentation with the appropriate identifying information
- Follow up with payers to verify they received the requested documentation
You can also have Beth queue up documents to be submitted internally by your office, have her submit them via fax or alert your team to drop them in the mail.