Medical Revenue Cycle Management

Applied Medical Systems

Decoding the Modern Revenue Cycle: From Patient Intake to Optimized Performance

In today’s dynamic healthcare landscape, Revenue Cycle Management (RCM) transcends basic billing. It’s the strategic engine powering financial sustainability, a sophisticated ecosystem that ensures seamless reimbursement from patient engagement to outcome analysis. Forget the outdated notion of a linear process; modern RCM is a continuous, carefully managed loop, driving efficiency and maximizing revenue integrity.

Think of it less as a checklist and more as a real-time strategy. Navigating the complexities of payer contracts, evolving regulatory landscapes, and patient financial responsibility requires a proactive, meticulously handled approach.

At Applied Medical Systems, we don’t just manage your revenue cycle; we architect its success with close attention paid at every step.

Here’s a glimpse into our refined, carefully executed approach:

  1. Thorough Patient Engagement & Precise Intake:

    • Front Desk Training: We know that your front desk is the key to patient engagement and accurate information … blah blah blah
    • Real-Time Eligibility & Benefit Verification: We work with multiple clearinghouses for instant eligibility checks and detailed benefit breakdowns, empowering front-office teams with actionable insights. We verify the data received.
    • We maintain constant, human-centered communication with our office, leveraging technology to enhance, not replace, the vital role of direct, personal interaction in problem-solving.

  2. Meticulous Coding & Clinical Documentation Improvement (CDI):

    • Expert Coding: Our certified coders, credentialed by AAPC and AHIMA, utilize advanced coding platforms to ensure accuracy and compliance. Every code is checked.
    • Integrated CDI: We collaborate with clinicians to optimize documentation, capturing the full scope of patient care and minimizing coding discrepancies. We review every document.
    • Value-Based Care Readiness: We ensure accurate coding and documentation that support quality reporting and risk adjustment models.

  3. Accurate Charge Capture & Rigorous Claims Scrubbing:

    • Electronic Charge Capture: We streamline charge capture through EHR integration ensuring all services are accurately recorded. Every charge is verified.
    • Advanced Claim Scrubbing: We leverage sophisticated clearinghouse and EHR rules engines to identify and resolve potential claim errors before submission, drastically reducing denials. We check every claim.

  4. Efficient Electronic Remittance Advice (ERA) & Precise Payment Posting:

    • Automated ERA Processing: We automate the ingestion and posting of ERAs, significantly reducing manual effort and accelerating cash flow. We double check the automated process.
    • Payment Variance Analysis: We analyze payment variances, flagging potential underpayments and contractual discrepancies. Every variance is looked into.

  5. Proactive Denial Management & Optimized Appeals:

    • Denial Pattern Identification: We identify denial patterns and proactively address root causes. We examine every denial.
    • Appeals Workflow: We generate compelling appeals with data-backed justifications. Every appeal is crafted carefully.
    • Payer Contract Management: We can monitor payer contracts to ensure compliance and identify opportunities for negotiation.

  6. Positive Patient Financial Experience & Digital Collections:

    • Compassionate Collections: We employ a patient-centric approach to collections, prioritizing clear communication and flexible payment options.
    • Personalized Patient Billing: We offer digital billing options, customized payment plans, and secure online payment portals.
    • Automated Patient Communication: We leverage automated messaging and reminders to engage patients and facilitate timely payments. We monitor these communications.

  7. Detailed Insights & Performance Optimization:

    • Real-Time Revenue Cycle Reporting: We provide comprehensive reporting  that offer actionable insights.
    • Trend Analysis: We analyze revenue trends, identify potential risks, and optimize revenue cycle performance. We review these trends closely.
    • Continuous Improvement: We leverage detailed insights to refine processes, optimize workflows, and drive continuous improvement.

Partner with Applied Medical Systems to transform your revenue cycle into a strategic asset. We empower you to focus on delivering exceptional patient care while we optimize your financial performance, with close attention to every detail.