EI RCM Revenue Cycle Management Services

Revenue Cycle Services

EI RCM offers a comprehensive range of revenue cycle services designed to streamline operations, maximize efficiency, and enhance financial outcomes for healthcare organizations

Front-End Revenue Cycle Services

Patient Scheduling and Appointment Management: Simplify the scheduling process for both providers and patients. Our system ensures smooth operations, high patient satisfaction, and reduced no-show rates through automated reminders.
Patient-Centric Approach: Prioritizing the well-being of patients through empathetic care coupled with exceptional service delivery—ensuring satisfaction at every touchpoint.
Eligibility Verification & Benefits Checks: Ensure accurate coverage determination before services are rendered. This proactive approach reduces claim denials and financial burdens on both patients and providers.
Prior Authorization Services: Expedite authorization processes by managing requests efficiently. We ensure compliance with payer requirements while facilitating timely care delivery for patients.
Patient Registration/Patient Demographics:Streamline data collection and verification processes to maintain accurate patient records. Our systems minimize errors during registration, enhancing the patient experience from the outset.

Mid-Revenue Cycle Services

Charge Entry & Charge Audit: Guarantee precise charge capture to optimize revenue flow. Our auditing processes identify discrepancies early, reducing revenue leakage.
Medical Coding Services: Ensure compliance with coding standards for accurate claims submissions. Our certified coders are trained in the latest coding guidelines (ICD-10, CPT) to maximize reimbursement potential.
Medical Coding Audit: Identify discrepancies in coding practices through regular audits. This process improves coding accuracy and compliance while providing insights into areas for improvement.
Clinical Documentation Improvement (CDI):Enhance the quality and completeness of clinical documentation. Our CDI specialists work with your clinical staff to ensure documentation supports medical necessity for services rendered.
Revenue Integrity:Maintain compliance while optimizing financial performance through regular reviews of billing practices and adherence to payer guidelines.

Back-End Revenue Cycle Services

Remittance Processing: Streamline payment posting and reconciliation processes. Our automated systems ensure quick updates to accounts receivable records.
Accounts Receivable Management: Expedite payments by actively managing outstanding balances. We employ best practices in follow-up procedures to reduce days in accounts receivable.
Denial Management: Identify, analyse, and resolve claim denials effectively. Our denial management team works diligently to appeal denied claims, increasing recovery rates.
Clinical Documentation Improvement (CDI):Enhance the quality and completeness of clinical documentation. Our CDI specialists work with your clinical staff to ensure documentation supports medical necessity for services rendered.
Credit Balance Resolution:Address overpayments efficiently through systematic reviews of accounts. We ensure financial accuracy while maintaining compliance with regulations governing overpayment handling.
Provider Enrolment and Credentialing Services:Ensure providers are properly credentialed with payers to avoid delays in reimbursements. Our streamlined processes facilitate timely enrolment for new providers joining your organization.

Market Segments

We serve a diverse range of healthcare organizations, tailoring our solutions to their unique needs:

Hospitals and Healthcare Systems

Patient Access Services: Improve patient experience through streamlined front-end processes that enhance access to care.
Health Information Management (HIM), Clinical Coding, and CDI:  Maintain accuracy and compliance in health information management practices.
Denial Management: Identify, analyse, and resolve claim denials effectively. Our denial management team works diligently to appeal denied claims, increasing recovery rates.
Revenue Assurance Services:Maximize revenue integrity while minimizing leakage through comprehensive audits.
Revenue Optimization Services: Enhance financial performance by identifying opportunities for operational efficiency across departments.

Medical Billing Companies

We provide comprehensive RCM support tailored specifically for medical billing companies seeking to streamline operations and improve cash flow management.

Dental Groups

Customized solutions address the unique needs of dental practices—ensuring efficient billing processes while maximizing revenue potential through targeted strategies.

Healthcare Payer BPO Services

We offer back-office services designed for healthcare payers:

Front-End and Digital Mailroom Services: Efficiently manage document workflows from patient intake through claims processing.
Claims Operations: Ensure accuracy and timeliness in claims processing with dedicated teams focused on reducing errors.
Denial Management: Identify, analyse, and resolve claim denials effectively. Our denial management team works diligently to appeal denied claims, increasing recovery rates.
Benefits Configuration Services:Simplify plan setup and administration for payers managing multiple benefit plans.
Premium Billing and Collections: Streamline premium payment management for health plans.
Provider Data Management: Maintain accurate provider directories through regular updates.
Eligibility and Enrolment Services: Simplify member onboarding processes while ensuring accurate benefits management.
Appeals and Grievances Management:  Efficiently manage appeals processes to ensure member satisfaction.
Omni-Channel Customer Services: Provide seamless support across multiple communication channels—enhancing member engagement.

Financial Improvement Solutions

EI RCM offers specialized financial improvement solutions designed to enhance revenue integrity:

Coordination of Benefits/Eligibility Verification: Minimize payment delays while reducing errors through proactive verification processes.
Claims Operations: Ensure accuracy and timeliness in claims processing with dedicated teams focused on reducing errors.
Overpayment Identification and Recovery: Overpayment Identification and Recovery:
Benefits Configuration Services:Simplify plan setup and administration for payers managing multiple benefit plans.
Fraud, Waste, and Abuse Management: Safeguard resources with robust monitoring solutions that identify potential fraud or abuse within billing practices.
Medicare Star Quality Rating System Support: Enhance plan performance by focusing on quality metrics that improve member satisfaction scores.

Care Management Services for Health Plans

We provide comprehensive care management solutions aimed at improving patient outcomes:

Utilization Management: Ensure cost-effective care delivery while maintaining high-quality standards across all services provided.
Telehealth and Virtual Nursing Services: Expand access to care through innovative telehealth solutions that connect patients with providers remotely—improving convenience without sacrificing quality.

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