RCM Solutions

comprehensive suite of revenue cycle management solutions to healthcare facilities across the world. Offering cost-effective services and high quality under affordable pricing is our specialty.

Beginning with a patient’s appointment seeking medical services and ending with final claims and payments being collected, the medical revenue cycle needs to be managed efficiently, in order to ensure patient safety and quality of care, while empowering the practice to achieve financial well-being.

• Eligibility Verification Process
• Demo / Charge entry
• Payment Posting
• Denial management
• AR Follow-up
• Patient AR follow-up
• Provider Credentialing
• Coding
• Insurance Authorization
• Health Care Credit Card

we understand the need for embracing technology to achieve effective revenue cycle management. We have the necessary platforms that seamlessly facilitate payer-provider interactions. We ensure that our clients keep up with the continuous evolution and rapid changes in the healthcare ecosystem and the regulations.

Strict control measures ensure high and guaranteed accuracy, thereby decreasing refusals and increasing reimbursements.

Lower cost structure and highly qualified staff give us the resources to analyze and resolve denials and to follow up lower – dollar claims and make collections.

Access to well-qualified college graduates, thus getting expert attention and enhanced productivity.

We focus exclusively on assisting Medical Billing and Claims processing companies only, and because of this, we have gained expertise across different software, billing methodologies, and state regulations.

We are flexible to accommodate all of your needs, no matter how demanding they are and scale the operation to best suit the size of your requirement. No task is too small or too large for us.

Your complaints or issues are handled by our 24/7 customer service department in a timely manner. We have a record of resolving complaints within an average of three hours or less.

Our business strategy is to complement you and not to compete against you.

Medical Billing Service Provided to an Independent Practice

Rapid Care played an efficient role in streamlining the revenue cycle for a medical practice in San Francisco, California. We provided solutions that helped this independent practice (Internal Medicine) to resolve filing issues, enrolment issues, and ensuring proper payments. We helped them reduce their total AR considerably, so that their collections increased by 60%.

This independent practice at San Francisco specializes in internal medicine. They have their own clinic and lab along with nurse practitioner. Approximately 1500 patients visit here each month.

This clinic was faced with several claim and payment-related issues. The following gives a brief summary of the payments outstanding

The strategy that we followed for resolving the issues of this independent practice is based on comprehensive process flow that is followed by different other activities till these issues are resolved finally.

We first identified the major payors – such as Medicare, Medicaid, UHC, BCBS, and others. The issues were resolved in order.

Incorrect billing and those not filed according to standard were resolved by changing the filing type.

When there was no update on change of address, we contacted the payors and arranged for change of address.

In cases of rejection due to not changing Medicare pre enrolment, our team got the rejection issue sorted with clearinghouses.

The practice became satisfied with our services and they have started working diligently toward their filing system improvement, error reduction, and streamlining of medical billing functions.

Infrastructure

• Best in technology, Computing, and physical infrastructure.
• Medical Billing Facility – Infrastructure
• Intelligent Building Management Systems.
• Dedicated Internet Facility
• Redundant Power Supply with UPS and DG as Power Backup.

Management Team

management and technical team, the company maintains its leadership position delivering Enterprise Medical Billing and Coding solutions and Medical transcriptions. This group of goal-oriented, results-driven senior executives guide the company to its next level of growth and success.

We are very comfortable at handling this critical phase of billing since we rigorously follow-up with insurance companies and patients right till the last cent, using legally prepared appeals (as per Medicare advice with respect to “appealing” denials rather than “re-submitting” them). As a side note, our appeals will always include and quote well-researched past “legal” precedents because of our collaboration with one of the better known attorney firms that specialize in this field.

We have in-house certified coders, who are normally required for around 20% of the claims. This enables us to hike collections just by timely catching down-coded errors by physicians, thus increasing the average levels billed for office visits. Especially when chosen to handle both transcription and medical billing, because we have direct access to the physician’s patient notes, we analyze the codes used on a regular basis, to not only check their validity, but also to see if the documents and service warrant a higher level procedure. We provide a free PCA (procedure and diagnosis code analysis) to our potential clients even before we start, and do it quarterly thereafter, as part of our service.

To ensure increased collections, we provide a week to two weeks’ training to the client’s staff on more efficient billing and data collection procedures, including eligibility checking and getting the correct pre-authorizations in a timely manner – all of which go miles toward increased collection and improved cash-flow.

Most medical billing companies charge between 8% and 12% of the amount collected, to their physician clients. We charge our clients, an average of 7 to 8% of the actual amount collected, after it is collected. That is substantial direct savings and cash-flow improvement to our physician clients, day on day.

Services Provided under Ongoing Basis

• Revise and update practice fee schedule
• Periodically update and re-attest CAQH documents/information
• Negotiate fee schedules with HMOs
• Provide alerts on license renewals and re-credentialing
• Patient Eligibility Verification
• Preauthorization
• Demographic and Charge Entry
• EOB Posting and Reconciliation
• Denial Management
• Account Receivables Follow-Up
• Patient Statement dispatch
• Secondary Claims dispatch
• Quarterly Practice Performance Analysis
• On Demand Customized reports

Health Care Consulting Services

• Provide Practice Management Software
• Provide Electronic Medical Records Software
• Assist with EMR Implementation
• Assist with eRx and PQRI Incentives
• Assist with EHR Incentive

Quality Assurance Process

Our quality checks at every step of the entire billing process life cycle. By ensuring accuracy and efficiency in data entry, coding, claim filing, AR calling, denial analysis, appeals, managing account receivables, generating periodical reports, and by carrying out periodical internal audits, Rapid Care is able to guarantee higher and faster realization of claims. We are thus capable of providing better cash flow to the clients.

Billing

We are with you right from eligibility verification till you get paid including appealing/reprocessing of declined claims. Our expert billers & certified coders can handle almost all medical specialties with equal efficiency. Billing is a part of our comprehensive health care support service and we have been in this business for over the last ten years and still growing.

• Practice Analysis
• Credentialing and Enrolment
• Eligibility Verification
• Pre Authorization
• Referral Management
• Demographic & Charge Entry
• EOB Posting & Reconciliation
• Denial Management
• AR Management/Follow-up
• Patient Receivables Follow-up
• Patient Statement Dispatch
• Secondary Claims Dispatch
• On Demand Customized Reports

Our Strengths

We have set up separate teams of certified coders who specialize in individual specialties which ensure precise and accurate coding. Our certified medical coding professionals are fully oriented to avoid down coding or up coding.

Our independent audit system not only ensures compliance with coding standards & methodologies but also helps us stay ahead of competition.

Quality Management

The Quality Management System helps us in :

Processes based on Six sigma best practices for all the elements across entire lifecycle of an outsourcing engagement