With your RCM subscription you get access to our dedicated customer service team, onboarding with our implementations team, and a dedicated billing specialist. This information is also available to download as a PDF.
- Claims Submission
- Claim Reconciliation:
- Rejections and Denials
- Payment Posting
- Claims Correction:
- Internal or Clerical - Researched and resolved by the assigned Billing Specialist
- External or Contractual, Clinical - Will take some provider involvement
- Reporting
- Billing Submission Report: Claims billed, claims exceptions, claims rejections
- Denial Report
KNOW:
- Key staff member(s) I want as a part of my implementation team.
- The services I provide, and their service codes and modifiers.
- Payer contracts, if my agency is credentialed, rendering staff or both.
- The status of my members' service authorizations.
- Insurance and/or MCO portal login information.
- The point person to respond to emailed reports/requests.
DO:
- Participate in the Implementation process (billing utilizing RCM does not occur until this is complete).
- Enter valid data for members during patient registration.
- Participate in Service Code Management.
- Create a delegate portal login for each insurance payer for the billing specialist.
- Keep an accessible, working email.
- Respond to emails and/or phone calls from the billing specialist regarding claims prior to the next billing submission date.