Revenue Cycle Management
UAMS provides superior and cost-effective revenue cycle management (RCM) solutions to all the clients. We help you to collect payments on submitted claims; increase the revenue from underpaid claims, and help in following up with insurance companies for quick settlements.
Why Choose UAMS for RCM?
UAMS is a revenue cycle management company with over 9 years of experience serving many facilities (Clinics/Medical Center/Hospitals/Labs). Our proven, flexible solutions and unrivalled dedication to service are the reasons why current customer referrals continue to drive our growth. Our specialized RCM expertise enables our clients to maximize revenue and minimize cost and compliance risks despite the challenges of a complex, changing healthcare economy. Key features of our RCM model include:
- Medical coding and billing servicesperformed by certified specialists
- 100% charge capture to ensure every service performed is billed
- Aggressive denial, appeal, and underpayment management
- Submission and re-submission of medical claims on daily bases
- Insurance follow-up and self-pay collections
- Analytics and reporting that deliver actionable insights
- Comprehensive accounts receivable management
- Experienced Staff: with minimum 5 years of experience in handling RCM system
- Up-to date software and technology: that helps in best productive functioning of the RCM
- No Risk Outsourcing: ensured by rigid information security procedures, practices and policies
When patient statements and claims are outstanding, it remains vital for physician practices and hospitals to closely monitor the process and intervene when necessary to optimize cash flow. Our revenue cycle services help to ensure payments are made in a timely manner. We also evaluate underpaid/non-paid claims by comparing any payments made to contracted amounts for the purpose of flagging exceptions. Following up with accounts is absolutely essential to achieving strong collections rates, and it should not be neglected.
How UAMS Revenue Cycle Management Process Works?
We work closely with the customer to understand their processes, expectations and facilitate a smooth and seamless transition. Our outsourcing model is dynamic and is customer specific however here are few guiding principles.
Business Associate Agreement & Service Level Agreement:
The Business Associate Agreement is mutually signed and is intended to fulfil the requirements contained in the final regulations issued by the HAAD (Health Authority – Abu Dhabi for UAE & DHHS (Department of Health & Human Services for USA) in the implementation of HAAD Policy (Manuals were published in December 2012 for UAE ) & HIPAA (Health Insurance Portability Accountability Act of 1996 for USA) and to ensure that each party is committed towards protecting PHI (Protected health information) to the highest standard of safety and confidentiality.
The Service Level Agreement (“SLA”) defines the outsourcing service quality standards and lays the foundation for the overall success of the relationship. The SLA is developed in collaboration with the customers and not only details scope of the outsourcing services and measurement metrics but also reflects each other’s values and professional goals. We also do not hesitate to sign a Non-Compete & Non-Solicitation Agreements with our customers to instil confidence and good faith.
Account Executive Assigned – Key point of contact
An experienced knowledgeable executive is assigned to every customer for handholding (handling) through the transition process and serves as a conduit between customer and the outsourced team. Once the services are established and active, the account executive will coordinate and communicate via phone or email at a customer defined frequency and/or as required by the customer.
Secure Remote Access, File Transfer Systems, VPN Tunnels
We will work with your IT support team to set up customer’s office computers and network for secure remote access as well as establish a file-transfer system for electronic transfer of files. In view of the sensitivity associated with the healthcare information all our teams work on fully locked down dumb terminal PC’s and have restricted remote access to customer’s software applications and tools required to accomplish the assigned job function in a secure manner.
Preliminary Training & Development
As we work on your software or system we always request some documentation on customer’s present process, training manuals for our teams to understand customer’s practice specifics and may schedule online meetings with customer’s current staff for better understanding of their processes. During this phase we would also request some demo accounts for our internal training and development.
MIS Reporting Requirements
We offer a variety of MIS reports & progress related reports based on customer needs however we can customize reports as per your requirements.
Revenue cycle management benefits include
- Increased average % of claims paid after 1st submission
- Increased average % of current claims (0-60 Days)
- Reduced denial rate
- Improved net revenue to the practice
- Higher percentage of clean claims
- Reduced outstanding accounts receivables
- Faster claims payment
- Less lost claims
- Improved quality of care by having more time for patient care issues
- Correct patient information available and less stress to your staff
In order to achieve compliance, healthcare providers must employ software technology and a centralized billing/coding system. Incorporating revenue cycle management processes as part of an overall business strategy often results in improved reimbursement, accurate billing compliance and great clinical outcomes.Having a revenue cycle management partner can help healthcare clinics operate more efficiently and in turn provide greater medical services to those who need it the most.
Outsourced Medical Billing Services For
- Doctors
- Medical Groups
- Hospitals
- Independent Physician Practices (IPA)
Roles and Responsibilities : (which rules and responsibility are these comes under rcm in website)
The roles and responsibilities have to be defined by you beforehand. The intention in doing so is that we work as an extension of your office and no duplication of any efforts is done. All the redundant work is dropped and a fairly simple paperless process is created to streamline the operation. We handle the entire process for our customers leaving them to concentrate on their practice and patient care.
- Improved Product / Service
- Increased return on investment
- Reduced costs the tune of 35-60%
- No or little infrastructure requirements
- Improved customer service/satisfaction
- Resource Availability in sync with demand
- Effective deployment or better use of capital
- Taking advantage of latest & future technologies
- Increased management focus on core strategic issues
- Improve performance & process efficiency in critical areas
- Depth of process expertise, access to subject matter experts
- Reduction of risk in terms of technology and/or skilled personnel
