Clinically Driven Revenue Cycle Management

Get more from your revenue cycle management company. Implementing a clinically driven revenue cycle is a significant step toward improving RCM performance and preparing for value-based care. It combines clinical, financial and operational health information to be available when and where it’s needed so health systems can optimize workflows, improve cost-effectiveness and, ultimately, build a healthier bottom line.

Keep reading to learn why we’re a true partner for your medical practice, composed of a team with deep knowledge and expertise within healthcare.

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What is Healthcare Revenue Cycle Management?

Revenue cycle management (RCM) is the process of tracking the financial relationship between a medical patient and the healthcare system. While the cycle has historically started at the point of rendered services, shifts to value-based care have also pushed the beginning of the RCM cycle earlier to the point of appointment scheduling and patient registration.

Proper revenue cycle management will include rendering all medical services into billable charges, proper coding, payment collections, and more, eventually concluding with the review of outstanding accounts receivable and analysis of medical services rendered.

RCM is a key aspect of your practice administration and our primary service.

We Build and Manage a More Profitable Revenue Cycle.

We are not your typical billing and revenue cycle management company. We have built and managed leading medical practices and understand what is happening on the practice side of the revenue cycle along with the nuances of operating a medical practice in the newer model of value based care. We have worked with practices throughout the country on clinical preparedness for a value based revenue cycle that delivers increased transparency, tighter clinical and IT alignment, a better patience experience and increased profitability for the practice.

Through an improved, effective, and efficient revenue cycle process including optimized coding, rigorous denial management, contract compliance, and advanced reporting and analytics; our practices typically see a 10-20% increase in their reimbursements.

Are you interested in learning more? Talk to us at 847-720-7499 or use our contact form.

Maximize Your Revenue Cycle Management With Our Other Services

With decades of experience with EHRs, budgeting, medical coding, navigating volume vs. value-based care, and management training, HIS can provide you with a comprehensive partner for all your practice administration needs.

Get more from your revenue cycle management company. Learn how we can help your practice profit with a free consult.

The Benefits of Working With HIS

HIS wants to be more than just a 3rd party for your medical practice – we want to be a true partner that your business can rely on for guidance and results. Some of the benefits of using us for revenue cycle management include:

  • Access to 30 years of day-to-day real world experience in healthcare administration
  • See increased reimbursements – most of our partners see a 10-20% improvement
  • Improved compliance to minimize denials or penalties
  • Accelerated cash flow from better processing and collection practices
  • We work with most EHR, DME, and other practice management technologies
  • One stop shop for accessing 200+ medical professionals that can synchronize your revenue cycle management as well as the rest of your practice administration.
HIS RevenueCycle 1
8 Areas of Your Revenue Cycle that Should be Closely Monitored

Our Leadership Team’s Experience

Our executive team, led by CEO and CHBC David J. Wold, COO David M. D’Silva, and VP Richard Sanchez, is deeply involved in healthcare management, including affiliations with the following entities:

Medical Group Management Association | National Society Certified Healthcare Business Consultants

Radiology Business Management Association | American Alliance of Orthopaedic Executives

Healthcare Billing and Management Association

Other experience also includes being President of the Foundation of Healthcare Management, serving on the editorial board of Physician Management Magazine, and serving as former president of both the Society of Medical Dental Management Consultants and the National Association of Healthcare Consultants.

Revenue Cycle Management Services

For the past several years, HIS has been a specialized revenue cycle management company for both orthopedic and radiology practices. Now we’re expanding our services to medical practices of all kinds. When you sign on for revenue cycle management, some of the primary services you’ll receive support for 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.

Medical Coding and Billing Support

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.

How Much ROI Will You See With HIS?

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.

Our partners see on average an increase of 11.2% in reimbursements.

Healthcare Industry Updates and Articles

Read our most recent blogs and news from the world of medical billing and practice management.

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E/M Documentation and Coding Changes for 2024
On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released final rules for the 2024 Physician Fee Schedule and Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. Keep reading to learn more.
Revenue Cycle
7 Revenue Cycle Concerns for Orthopedic Practices and How to Fix Them
Managing a revenue cycle in the medical field is no easy task. Below are some concerns for orthopedic practices and recommendations for monitoring the health of your revenue cycle.
Doctor Using Tablet
The Importance of Accuracy and Compliance in Billing and Coding
Always Ensure Accurate and Compliant Billing and Coding When managing a medical practice, you undoubtedly have several things to worry about at any given time. Medical billing and coding is difficult to keep up with, especially with evolving laws, regulations, and medical codes. These changes make it difficult to be compliant even for the most […]