Revenue Cycle Management
& Consulting Services
From Root Cause Analysis to Solutions
Why choose RCA Solutions?
Business process
Fueled by an unwavering passion for efficiency, we have embraced the principles of Lean Six Sigma across every facet of our business. Our relentless pursuit of continuous process improvement is at the core of everything we do.
End-to-End Management
Our journey in the revenue cycle industry began with a focus on the back-end processes, specifically handling intricate appeals and patient collections. This experience granted us a distinctive perspective on the far-reaching consequences of poorly managed processes upstream. At RCA Solutions, we take a comprehensive approach to evaluate the entire revenue cycle. We assist providers in optimizing their intake documentation and processes, ensuring compliance with payor-required forms, all with the ultimate goal of maximizing their revenue.
Dedication
Throughout our journey, we have come across countless providers who find themselves in a state of confusion regarding their billing operations. Whether they have experienced poorly managed billing in the past or lacked the efficient processes we implement, these providers are seeking guidance and support to rebuild their trust in a billing partner. We view this as an invaluable opportunity for growth and improvement, and we wholeheartedly embrace it.
Transparency
At RCAS, we firmly believe that your data belongs to you, without any ambiguity. We uphold complete transparency and ensure that no details are concealed from you. Our policy is straightforward: if there's anything you want to know, simply ask. We are committed to providing you with open and honest access to all the information you seek.
Revenue Cycle Management vs. Insurance Billing
While some individuals may use "Insurance Billing" and "Revenue Cycle Management" (RCM) interchangeably, it's important to note that they have distinct meanings. Insurance billing and collections represent a specific component of revenue cycle management. RCM, on the other hand, goes beyond focusing solely on the specialized aspects of quality insurance billing and collections. It also encompasses an assessment of the associated processes, aiming to identify opportunities for waste reduction and profit increase at each stage. RCA Solutions RCM adopts a comprehensive approach that seeks to enhance efficiency, optimize reimbursement, minimize claim denials, and ensure financial stability by integrating and managing various revenue-related functions.
Our Revenue Cycle
Revenue cycle management is a financial sequence of processes that start when a patient makes an appointment with a provider and ends when a claim receives final payment. For the medical practices we serve, the steps are:
Insurance Verification & Eligibility
Why we do it best: we learned the insurance billing process as a result of managing the appeal process. We know what to ask to verify your patient’s benefits and our turn-around time on VOBs is a top priority
Render billable services
Keeping providers focused on patient care is our top priority
Code EHR & Submit clean claim
Our team will work with you to ensure optimal coding and pricing strategies are utilized.
Claims Management
Our team diligently follows up on all submitted claims, making sure that you are given ample time to fulfill additional information requests.
Payment posting
We don’t just post payments to the billing system. We review and record every claim determination for your office. When a claim is paid less than you deserve, we follow-up on those claims to make sure you get the payment you deserve.
Claims collection
Our team is experienced in complex appeals and denial management. We do not give up at the first, second, or third round of appeals. We will continue advocating for the patients our clients serve, until the very end. We consider ourselves the patients’ financial advocate.
Reporting
We provide the data for you to make well-informed strategic decisions.
Benefits of Choosing RCA Solutions
Increased Revenue: Our comprehensive approach to insurance billing ensures accurate claims submission and faster reimbursement, maximizing your revenue potential.
Expertise and Experience: Our team has extensive experience in Revenue Cycle Management. We stay up-to-date with the latest industry regulations to ensure compliance and minimize claim rejections.
Time and Cost Savings: By outsourcing your insurance billing to us, you can save valuable time and resources. Our efficient processes and advanced technology minimize administrative burdens and allow you to focus on patient care.
Customized Solutions: We understand that every healthcare provider has unique requirements. We tailor our services to match your specific needs, providing personalized solutions that align with your goals and objectives.
