RCM process coordination strategies for Multi-speciality hospitals

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2. INTRODUCTION : Hospitals and medical groups with multiple specialties always struggle to coordinate between various departments as specialist physicians need to coordinate with screening labs, radiologists, and other specialists to create a progressive treatment plan for the patient. Sometimes this process is interrupted and the patient’s progressive care is put to a halt receiving a bad reputation amongst the patient population. Interconnected RCM processes in multispeciality hospitals are essential to achieving financial and patient care goals. We have listed down a few areas where your multispeciality can perform well if organized properly. INTERNAL COMMUNICATIONS : The same platform designed to monitor resources is also used to perform day-to-day internal communication between the respective departments and RCM teams. A few of the notable features of internal communications are: www.billingparadise.com

3. FRONT OFFICE TO RCM TEAMS : It is a well-known fact that the front office in every healthcare organization is the first point of contact when it comes to registering patients. Coordination between the front office and the patient eligibility and benefits verification department must be interconnected so that the doctor treating the patient can engage in more benefits-related conversations with the patient. This internal communication feature will allow front office staff to assign the patients whose appointments are fixed in the upcoming days to the eligibility and benefits verification department and then the verified data will be communicated and forwarded within this platform itself. WORK ALLOCATION : Using this platform allows each and every department to assign work according to the revenue cycle process. For example: After patients, eligibility and benefits are checked we can forward the verified patient data to the Demo and charges team to capture the information and transmit the claim to the insurance companies. This shortens the time of email. Communication, because as soon as the work allocation is done the respective department head will be notified within seconds including the message from the eligibility department. www.billingparadise.com

4. TICKETING SYSTEM : Ticketing or raising queries is an important part of this platform. Whether it is from the hospital or clinic side or with the RCM team’s side, Raising tickets in regards to completing tasks or rectifying certain process issues all are done using this Ticketing option. This ticket is visible through the management hierarchy and the RCM directors and managers can track whether the queries are solved or not as the open-closed or in-process categories are listed in the tickets allowing a smooth process among the respective departments/teams. UPDATES AND TRAINING : Training is a vital part of every RCM process. Setting up daily targets and updates can be easily conveyed through the internal communications option. Process trainers can pay close attention to the work done by the RCM team and can provide necessary feedback to the staff who need to improve and internal quizzes, and Q&A sessions can be conducted using this platform’s internal communications feature. www.billingparadise.com

5. LEAVE REQUESTS AND TRANSFER OF WORK : Staff who are looking to apply for leaves can directly communicate using the option leave application. This request will be directly sent to the reporting authority of the particular RCM team or the hospital/clinic management. During the absence of any staff transfer of work to other RCM staff can be applied using the internal communications features. This allows a non- stop workflow even when an RCM or clinic/hospital staff is on leave. PRE CLAIM AND POST TRANSMISSION PROCESSES : Streamlining pre and post-claim transmission RCM processes will allow RCM staff to reduce human error and complete tasks in a fraction of the time compared to manual verification and paperwork. www.billingparadise.com

6. ELIGIBILITY AND BENEFITS VERIFICATION : Eligibility and benefits verification can be a burden when there are higher patient volumes each day. Front office staff cannot concentrate on this and assist patients simultaneously. Streamlining the eligibility and benefits process in hospitals and medical groups can obtain eligibility and benefits information specific to the specialty including out-of-pocket expenses for 100s of patients within 5mins. This data can be forwarded through the internal communications system. To the front office so that they can present the information to patients and providers during visits PRIOR AUTHORIZATION SIMPLIFICATION Obtaining prior authorization is a tedious and time-consuming process. Usage of automated systems which can fill the authorization forms for you and send the documents electronically is the best approach our automation systems provide you. It will indicate if the application is accepted and the current status whether it is approved or denied are all shown in our prior authorization automation system. www.billingparadise.com

7. CHARTS AND CODING ANALYSIS The interconnected platform allows the medical records department in the clinic/hospital to obtain coding reviews by forwarding the charts to the RCM coding team so that they can be analyzed before submitting the claims to avoid coding errors both in CCI edits and payer end edits. CHARTS AND CODING ANALYSIS The interconnected platform allows the medical records department in the clinic/hospital to obtain coding reviews by forwarding the charts to the RCM coding team so that they can be analyzed before submitting the claims to avoid coding errors both in CCI edits and payer end edits. EOB TO ERA CONVERSION Most insurance companies have electronic payment methods where the data is sent in EDI ERA format. Other payers like TPAs, IPAs, Auto Liability, and Worker’s compensation send out manual checks and EOBs which are overlooked in the mail room. These documents are converted to ERA format through our EOB to ERA conversion automation system. This allows less time in consolidating the manual paper records and posting them one by one on the EHR. This also gives the clinic/hospital complete accountability for the other payer’s documents and payments. www.billingparadise.com

8. PATIENT STATEMENTS AND PAYMENT TRACKING All RCM processes do not come to an end until the out-of-pocket expenses such as deductible or copayment are still pending in the patient balance. Our automated patient statement system will automatically send patient statements through email, text messages, or mail. Most patients like to pay their bills online and the payment pathway link is included in these statements, allowing the patient to pay directly credited to the clinic/hospital’s bank account. We have created proven and efficient methods that multispecialty hospitals can function better without any hassle and financial burdens. BillingParadise and our experts have created a well-performing RCM workflow that involves both manual staff and automation creating harmonious multispecialty RCM operations. Reach out to our RCM excerpts to find out more! www.billingparadise.com

9. CONTACT US +1 888-571-9069 inquiries@billingparadise.com BillingParadise 24x7 INC 53 Emerald Road, Robbinsville, NJ 08691. United States.

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