Revenue Cycle Management

RCM Management Services for Physicians and Healthcare Practices

Revenue cycle management (RCM) is the process of managing a practice’s revenue from payers based on the services provided to them. At Healthcare Information Services, we offer RCM services to clients across the United States, with our headquarters located in Park Ridge, Illinois. It is important for healthcare companies to implement successful RCM processes in order to ensure financial viability and consistently deliver high-quality care to patients. A reliable and effective revenue cycle process can drastically speed up turnaround time and make your office more efficient. 

Healthcare Revenue Cycle Management Services

Healthcare Information Services provides revenue cycle management to orthopedic and radiology practices. The primary services that fall under RCM include:

Claims Submission

Before a claim becomes eligible for payment, it must go through a multi-step procedure. A main factor in determining the speed of the claims process is how quickly you and/or your patients provide the necessary documentation to the insurance company. If you have the tools in place to weed out common errors, most claims should be processed within a few weeks.

Cash Posting

Once a claim has been submitted and reviewed, the payment will be posted and able to be paid by your patient. It is vital for your practice to utilize fee schedules, since they are the basis for how much a physician can make on a procedure. Working with HIS for your revenue cycle management will make this a seamless process for you, the provider, and the patient.

Denials Management/Resolution

Are you keeping track of how many claims get denied for your services? Overlooked claims can cost your practice a significant amount of revenue. HIS can take the burden off of your shoulders by executing denial management and resolving incorrectly filed claims. This may bring light to patterns of inconsistency, which can help you improve workflow. 

Appeal Management/Resolution

It is important to ask “Why?” when a claim gets denied. Sometimes a denied claim can be appealed, however it should be submitted to the insurer in a timely manner to avoid missing a filing deadline. HIS will review the insurance company’s rationale for denial and provide a thorough list of reasons why we disagree, backed by supporting evidence. Be sure to follow up after submitting an appeal to determine whether it has made a real impact.

Coding

Coding is a crucial element in the revenue cycle. It starts with a patient encounter in a physician’s office, hospital, or other medical care facility. Then, a provider details the visit or service in the patient’s medical record to explain why certain services, items, or procedures took place. Accuracy in clinical documentation is imperative for coding – especially when a claim arises. HIS offers surgical coding and coding education services to clients, which many other physician management companies do not. 

Meet Our Executive Team

At HIS, our experienced executive team is involved in all aspects of our business, as well as the success of our clients’ businesses. They are highly-skilled in the industry, especially RCM, providing clients with the necessary tools and expertise to grow their practices. 

 

  • David J. Wold, CHBC, CEO

  • David M. D’Silva, COO

  • Richard Sanchez, Vice President

 

Best Revenue Cycle Solutions 

At HIS, we have three decades of experience working with medical professionals from orthopedic and radiology practices. Our goal is to provide clients with comprehensive revenue cycle management and billing solutions that will make your practice more efficient, increase compliance, and boost profitability. Clients usually see an 11.2% increase in overall reimbursements when outsourcing their RCM to us. Contact us today to speak with one of our specialists about how we can be an asset to your practice.

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A More Efficient Billing & Revenue Cycle

Don't leave money on the table. This checklist will help you discover areas of opportunity to make the management of your revenue cycle more efficient.