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End-to-End Acute Care Billing Services You Can Rely On

Optimized Billing and Reimbursement Solutions
for Acute Care Providers

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Precision Billing for Acute Care Excellence

The intervention of acute care is incredibly important as it’s often lifesaving and performed within the first 24 hours following an emergency. Acute care billing is a complex affair as the providers face dual challenges of delivering high-quality care while simultaneously managing the labyrinth of billing protocols, coding intricacies, and regulatory requirements. The inability to efficiently manage these complexities can result in revenue leakage, non-compliance, and operational inefficiencies.

We, at RCM Workshop, understand these challenges which is why we provide customized billing services for acute care at various setups including post-acute care. With a deep understanding of billing and coding for acute care, our team verifies eligibility swiftly and improves coding turnaround times, clinical documentation accuracy, and navigation of CMS regulations and guidelines. We work in perfect collaboration with your current setup to optimize your financial performance, reduce denials, and enhance cash flow allowing you to do what you do best-delivering excellent patient care. 

Unbeatable Service, Quality & Price

ACCURACY
0 %
TURNAROUND TIME
< 0 Hours
COLLECTION
0 %
PRICE
Starting from $ 1100 /Month

Challenges

Challenges in Acute Care Medical Billing

Accurate coding: Acute care involves a wide range of treatments, from emergency surgeries to intensive care, and the complexity of these procedures requires precise coding. Errors in ICD-10, CPT, or HCPCS codes can lead to claim denials, delayed payments, or underbilling. Aligning clinical documentation with acute care surgery billing and coding requirements is essential but often difficult in fast-paced acute care environments. 

Insurance verification: Given the urgent nature of acute care, there is often little time to verify patients’ insurance coverage or obtain necessary pre-approvals. This can result in claim rejections or patients being left with unexpected out-of-pocket expenses. Proper coordination between the clinical and billing teams is crucial to mitigate these issues.
Integration of EHR with billing systems: Discrepancies between clinical documentation in EHRs and billing systems can result in delayed or incorrect billing. Seamless integration is necessary for accuracy but can be difficult to achieve.

OUR PROCESS

Our Acute Care Billing Process Workflow

Acute care services require precision in coding that accurately reflects the severity of the patient’s condition, and the complexity of care provided. Our team of certified billers and coders ensures each case is coded with precision, aligning with the latest ICD-10 and CPT standards. This helps to mitigate the risks associated with improper coding and delayed reimbursements.
Our acute care billing workflow is designed based on industry-standard RCM best practices and follows a structured process management framework giving complete visibility of outcomes at every stage of billing to our clients at a regular interval. Our stringent review and audit protocols ensure every service, procedure, and resource utilized is accounted for and billed appropriately, minimizing revenue leakage. Our meticulous review is part of our standard operating procedures to ensure quality and compliance in billing.

Scheduling & Registration

Carry out well-coordinated appointment Scheduling, update insurance details, and handle inbound and outbound calls from/to patients.

Eligibility & Benefits Verification

Confirm patients’ primary and secondary insurance and verify their benefits coverage, co-pays, co-insurance, and deductibles. 

Prior Authorization

Initiate request for prior authorization with the payer, follow-up to check Auth status till closure and finally update the system with Auth approval reference number.

Medical Coding

Check the accuracy of codes and modifiers according to specialty and assign corresponding and appropriate charges to the codes.

Charge Posting

Enter the charges for the services provided into the billing system including the cost of the medication and the administration fee.

Claims Edits & Submission

Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.

Payment Posting

Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.

Denial Management

Analyse and categorize denial claim according to denial codes, $ amount and payers, and resubmit claims after correction.

AR Management

Follow-up with payers to gather status for unpaid claims, and their resolution.

Patient Collection

Sending patient statements and follow-up with patients for final and outstanding payment.
You can confidently rely on us to manage your entire billing process, or you have the flexibility to select specific DME billing services that suit your needs, ensuring a seamless operation without any interruptions.

BENEFITS

Outcomes guaranteed

We use industry best practices along with our analytical driven approach which helps us to optimize the revenue cycle processes whilst maintaining the upmost quality. We do not just manage your revenue-we enhance it. Our acute care billing services are designed as per your workflow, ensuring you get a much-improved financial outcome.

Efficient Benefits Verification

>99% clean claim submission

Efficient authorization management

<24 hours turn-around time

Efficient Charge Entry

Efficient processing for flawless financial records.

Efficient denial management

<5% claims denials

Proactive accounts receivable follow-up

<40 days AR & reduced aging

Better coordination & process optimization

improved patient satisfaction

WHY US?

Why partner with us

Our comprehensive revenue cycle management services encompass every facet of acute care billing, designed to elevate your financial health. We provide you with dynamic, scalable solutions that enable you to implement effective strategies to tackle the toughest billing challenges head-on. Our advanced analytics and meticulous review processes significantly reduce claim denials and boost claims submission rates. Outsourcing acute care billing services to us means paving your way to achieving exceptional outcomes that will both stabilize your revenue streams and drive substantial improvements across your entire billing process. 

Guaranteed Improvement in Reimbursement and
Cash Flow

Reduction in Denials
and AR

Transparent reporting
– NO BLACK BOX

100% data security
& HIPAA compliance

On demand scale up
of operation

Significant Reduction
in Cost > 75% Savings

Simple & No
Cost transition

Flexible & Unbeatable
Pricing Plan