Revenue Cycle Management

Revenue Cycle and Profit margins are the lifeline of medical services. The health and success of your services is proportionate to the efficiency of your revenue cycle. 3Gen offers you skilled resources that specialize in accounts receivable as well as denial management. Extensive knowledge and experience of medical billing across multiple specialties, multiple platforms and various insurances & denials makes us a predominant driver of your timely cash flow. Our teams strive for the best results. Swift collections and improved cash flow is ensured through our AR management services.

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  • Appointment Scheduling & Patient Registration +

  • Eligibility & Benefits +

    Verification of Eligibility and Benefits is of vital importance before the services are rendered. The timely determination helps providers to get a clear view of patient’s coverage, Out of Network benefits and accurate information of other benefits such as vision, dental, etc.
  • Pre-Authorization +

    • Determine the Prior Authorization requirements
    • Preparing & submitting requisite information to insurance
    • Follow-Up on submitted documents
    • Identifying authorization issues and notifying providers
  • Coding & Audits +

    Coding is a crucial component of RCM. It’s imperative that rendered services are coded correctly & be more specific. This includes the appropriate use of CPT, Diagnosis Codes and Modifiers. With the vast expertise that our coders bring, we are able to efficiently and accurately code the services in compliance with ICD-10 guidelines. We pride ourselves in having a separate audit team, which specializes in comprehensive review of the services coded.
  • Charge Entry & Entry Audits +

    Charge Entry

    The main challenge faced by providers is of Charge entry and Turnaround time. We have reduced turnaround time for such practices from 72 hours to 24 hours. This includes reviewing of the superbills and submitting clean claims to insurances via clearing houses or paper submission within the stipulated time frame.

    Entry Audits

    The most common error while entering the charges is Human Error. We help in reducing such errors and increasing the efficiency. With our current clients, the charge entry errors were reduced up to 5% which helped in submission of clean claims, lesser denials and lower AR days.

  • Payment Posting - Automatic & Manual +

    Automatic: The current technology makes it easy for all insurances as well as patients to make payments electronically. Electronic Remittances contain high volume of payment transactions. We process the batches and segregate them into denials & payments for further processing.

    Manual: Explanation of Benefits (EOB) received via mail is captured in form of scanned images. The information captured is posted to each patient account and claim.

  • AR Calling +

    AR Calling is of vital importance post claim submission. It identifies the adjudication status of the submitted claim and helps in understanding the outcome of the claim. The early notification of denial helps in correcting the claim at the initial stage and saves it from getting ‘Untimely’ for appeals or corrections.
  • Denial Management +

    This is one of the most critical vertical of RCM. A major portion of the revenue is stuck here and requires additional attention. We have a dedicated team for denial management who are experienced in identifying different types of denials and providing corrective action for them. We send out periodic reports to providers by identifying common denial types and ways to avoid it for future submission.
  • Patient Statements +

    There is a portion of revenue that is dependent on Self-Pay or patient payments, which makes patient follow up very important. We help in sending out statements on a regular basis and generally follow up with patients as per clients’ needs.
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In a nutshell

  • Reduced AR days up to 25%
  • Increased collections by 10%-15%
  • Reduced write-off percentage by 8%
  • Reduced claim filing time from 72 Hours to 24 Hours
  • Pilot to Live Production within 5 days

Benefits

  • Corrective and Preventive Action (CAPA) for RCM
  • Keeping claims error-free
  • Reduce your administrative costs and increase your Return of Investment (ROI)
  • Expert revenue cycle specialists in all major specialties
  • HIPAA complaint
  • Customized MIS reporting
  • Verification and Submission of clean HCFA-1500 or UB04
  • Platform Agnostic

Do you need a consultation?

3Gen can help. Get to know your benefits.

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