Revenue Cycle Management Services

Optimize your RCM to the Fullest

Raising Healthcare RCM Value Chain through Our
Outsourcing Services

MedBillingExperts has over 13 years of experience in providing healthcare revenue cycle management services to hospitals and other healthcare practices in the US and around the world. Our comprehensive RCM services aim to reorganize your revenue cycle model to make it more efficient, quick and adaptable. We combine the power of our team, experience, knowledge, process and technology to maximize your chances of getting paid more without the hassles of delays and significant investments.

Keeping pace with a rapidly changing reimbursement model is a constant challenge for your healthcare revenue cycle process. Our healthcare RCM process helps you to remodel your revenue system to weather any storm. We bank on a streamlined practice workflow and optimized time management process to make your hospital revenue cycle withstand the highs and lows of regulatory changes. At the same time, we tap into the expertise of a highly specialized team to help you identify areas of under-performance, and unrealized reimbursement opportunities.

End to End RCM Services from a Team you can Trust

Our robust service are geared towards more than 80 specialties, covering the entire healthcare revenue cycle operations- from claim creation, quick submission, aggressive follow-up, denial management, appeals, payment posting and reporting — to help you get paid 30% more, 45% quicker.

Hospitals and other healthcare practices have benefited by outsourcing following RCM solutions to us:

Patient Demographics Entry

We collect and verify the patient demographics received during the patient visit. In case, the patient is already registered in the medical billing system, new information is verified and updated swiftly.

Insurance Verification Process

Our insurance eligibility verification process includes-

  • Receive patient schedules from the hospital via fax, email or EDI
  • Verify patients’ insurance coverage
  • Contact patients for additional information
  • Update the billing system with eligibility and verification details including member ID, group ID, co-pay information, coverage start and end dates, and so on

Charge Entry Services

A highly trained team of medical billing professionals handle charge entry process as follows-

  • Charges are entered into the clients medical billing system in accordance with account specific regulations
  • Withheld or pending documents are sent to the client for clarification and on a pre-determined schedule
  • The final charges are thoroughly reviewed by the quality team and clean claims are filed

Electronic Claim Submission

We give utmost importance to the privacy and security of patient data and ensure that claims are only transmitted electronically. This reduces processing delays and ensures high readability, thereby assuring that no claims are rejected due to illegibility.

With electronic claim submission, tracking claims become easier, corrections can be made instantaneously and there won’t be any lag in receiving carrier confirmation reports, all of which will go a long way in avoiding costly rejection.

Payment Posting

We post all the payments received from patients and insurance companies to the patients’ accounts in the clients billing system. Once this is done, the posted payments are balanced against the deposit slips and checks are done for any inaccuracies or underpayment to ensure accuracy in payment.

Checks and balances are also carried out on electronic posting of payments into the billing software and necessary documents related to EOB (Explanation of Benefits) are stored for future reference.

Denial Management

We understand that data plays a crucial role in plugging the torrent of unpaid claims. Hence we have made data analysis an integral part of our denial management services and ensure that every claim that is being denied by your payers is thoroughly scrutinized. Leveraging this level of intelligence, our denial management specialists can easily spot and fix the issues that are leading to the denials (whether it be issues with the claims or issues with the payers) and stop the stream of unpaid claims into your hospital revenue cycle. Once we do this, you can expect an inflow of additional 20% to 30% of revenues into your healthcare practice.

Accounts Receivable Management and Follow Up

MedBillingExperts’ AR management team can address every possible difficulty that can affect cash inflows to your organization. Our goal here is to collect every penny owed to you as quickly as possible and plan to achieve this by accelerating cash flows and reducing the AR days — by streamlining the medical claim submission process, increasing clean-claims rate, carrying out proper root-cause analysis of claim denials and ensuring regular follow-ups with insurance companies as well as patients for outstanding dues and payments.

Our outsourced Accounts Receivable management solutions also include the following optional services:

  • Handling of Refunds
  • Secondary Claims Filing
  • Insurance and Patient Follow-up
  • Handle Appeals for contested claims
  • Generate and mail patient statements
  • Indexing of documents to the patient accounts
  • Prepare Customized management reports

Medical Coding Services

Our experienced and AAPC certified coders excel in providing the following outsourced medical coding services:

  • Offshore coding audits
  • HCC medical coding
  • HCPCS, ICD-9 and ICD-10 coding including ICD-10-CM, ICD-10-AM, ICD-9-CM and CPT-4 medical coding
  • Payer specific coding services
  • Chart Audits and Code Reviews

Here are some of the services that differentiate MedBillingExperts apart from the rest:

  • Process mapping of revenue cycle workflow
  • Account management and customer service-
    • Front desk process review
    • Provide account management support, meetings and onsite visits
    • Allow client to audit files at any time to ensure proper billing practices
    • Provide direct access to our in-house healthcare support team to resolve any issue or answer any questions at any time
  • Proprietary analytics and business intelligence reporting

The Steps Involved in Revenue Cycle Management Solution Include:

Revenue cycle management steps

Patient Scheduling and Verification

The process begins with patient scheduling and having it on the right track keeps you moving in the right direction. To ensure this we employ skilled front-desk staff with adequate experience in scheduling visits and verifying and submitting important patient-related information.

Streamlined Documentation

During this stage we streamline the billing and collection process with clinical documentation, charge collection, pre-billing edit, electronic claim processing, document image retrieval, etc. The entire process is handled with great care and attention to details.

Complete Coding and Billing

This is the most crucial phase of the workflow. Our coders handle all medical coding specialties, including radiology and anesthesiology in keeping with ICD-10 coding standards. All our coders are certified (CPC, AHIMA, etc. certified) and so we guarantee accuracy of the highest order.

Complete Denial Management

In the event of a denial, we carry out proper analysis to identify the root cause of denials. This greatly helps us reduce future denials. We are experts in analyzing denials, timely filing of denial appeals and following up with payers to rebilling.

Comprehensive Accounts Receivable Management

We have a well-established process to reduce accounts receivable resolution time by at least 30%. Our process analyzes the reasons for delays, based on which we build a solution to reduce time for collections.

Healthcare Analytical Solutions

We enable you to make better-informed decisions through detailed, real-time reports and forecasts. You get access to the reports on any computer or mobile device.

Softwares to Streamline Your RCM Process

We are specialized in operating with the following softwares:

  • Kareo
  • Advanced MD
  • Healthfusion
  • Nextgen
  • Avant MD
  • AllScript
  • ZB
  • BrightTree
  • Medisoft

Explore Revenue Cycle Management Services from a Team You Can Trust

We don’t believe in a one-size-fits-all approach. Instead, we analyze your operational needs to tailor a go-forward plan to help your revenue cycle process remain on top of regulatory changes.

A premium revenue cycle management company, you can reap many benefits including:

  • 97% claims on first submission
  • Highly specialized RCM team
  • 20 days’ average medicare turn around
  • HIPAA-compliant process
  • 24 hours’ access to reports
  • Up to 40% savings on operating expenses
  • 24/7 support and services from 8 global delivery centers
  • State-of-the-art systems and software
  • Strict information security policies and practices

When you choose MedBillingExperts, you’ll partner with a revenue cycle management company focused on your financial interests and collecting the maximum revenue you’ve earned.

Contact us today and discover the advantage of outsourcing RCM services to MedBillingExperts

Get a Quick Quote

We respect your privacy Read Our Policy

Hippa & RBMA logo


Revenue Cycle KPIs Practices Should Track in 2018

Tracking key performance indicators (KPIs) does not mean that healthcare providers and practices have to end up drowning under a deluge of them. Picking and choosing what KPIs need to be tracked in a revenue cycle ensures that practices get a clear picture of how claims are handled  Read More

10 Best Practices to Keep Medical Staff HIPAA Compliant

Health Insurance Portability and Accountability Act (HIPAA) has become a bugbear, as its compliance is not facile but violation may charge the institution with massive fine. But, the good news is that if basic guidelines are followed on a regular basis than full compliance can be assured with zero chances of fine.  Read More

The Change from Fee-for-Service to Value-based Care and its Impact on Revenue Cycle

Transitioning from a Fee-for-Service to a Value-based Care system is rocking the healthcare industry. With Medicaid patients bringing in less profit and Medicare patients generating margins of minus 5% on average, providers are bracing for revenue to go down further while putting in place methods for tracking patient health and complying with new regulations.  Read More

5 Must Follow Steps for Accelerating Healthcare Revenue Cycle

The healthcare industry is evolving rapidly, making physicians responsible for not just correctly diagnosing the patients but also fulfil administrative responsibilities. As a result, it is becoming increasingly difficult for the physicians to stay focused on patient care. However, to take the administrative worries off their hands. Read More

5 Steps to Perfect Patient Collections

Don’t want to see patient collections dying a slow death in your practice, and instead want the process to operate like a fine-tuned machine? Then you are in luck as practices are increasingly putting in place methods to collect all money due to them efficiently and on time, and you can follow their example. Read More

Six Warning Signs that Indicate You Should Outsource RCM Services

Dealing with reduced revenue, while struggling to keep a hospital or clinic in tune with reimbursement regulations is a slippery slope many providers face when in-house revenue cycle management is used. Read More