DETAILED PROCESSES
Workflow & process management
According to Merriam-Webster Dictionary the first use of the word “streamline” was 1913 and the first use of the word “workflow” was 1921. The words “streamlined workflow” have been used together for nearly as long, but what does it mean? At ACP Billing Services we have detailed processes for every step of your revenue cycle that are proven to streamline workflows and increase profitability.
ELIGIBILITY VERIFICATION AND PRE-CERTIFICATION
At Procare RCM, our team completes pre-authorizations and insurance eligibility 12-24 hours prior to the visit. We call the insurance company and verify online to ensure reimbursement and reduce denials.
- Telephonically and Online
- 12-24 Hours Prior to Patient Visit
- Ensures Reimbursements
- Reduces Denial
- Procare RCM and Coding Team are AAPC Certified
- Certified Professional Coders (CPC®)
- Certified Inpatient Coders (CIC®)
MEDICAL CODING OF DIAGNOSIS, PROCEDURES, AND MODIFIERS
Don’t just hire a Coder. Hire a Coding Team. With the right Coding Team, your business will benefit from correct applications of ICD-10, CPT®, HCPCS Level II, and modifier coding assignments.
PATIENT AND CHARGE DATA ENTRY
Hire a separate audit team to verify your patient demographics and charge entry accuracy and your Clean Claim pass rate could match Procare RCM client’s rates of 99%. What does a Clean Claims mean?
- No Rejections
- No Preventable Denial
- No Errors
- No Filing of the Claim More than Once
Why Medical Practices Use Procare RCM:
- Reduced Billing Cost
- Improved Cash Flow
- Paid Timely
- Reduce Redundant Data Entry
- Improves Revenue and Billing Efficiency
- No Setup Fees
- No Training Costs
CLAIM SUBMISSIONS AND EDI
Investing in the right electronic claim software or EDI clearinghouse to manage your business is crucial to successful collections. With the right system in place and the right team, claims can be easily submitted to payers, flagged for follow up, and tracked through every step of the revenue cycle.
SOFTWARE SOLUTIONS
Whether you have your own software solution or need a recommendation, Procare RCM has years of experience with all different platform solutions. We can start immediately on your billing or get you setup with new technology to expedite your claims and have a proven 99% FPA (First Pass Acceptance) rate.
- Over 13 Years of Practice Management, Billing, EDI, and EHR/EMR Experience
- Experience with Over 65 Different Software Platforms
- We Provide Recommended Software Solutions that Support over 45 Specialities
- Proven 99% FPA (First Pass Acceptance) Rates on Claims
Partner with a company that not only post payments accurately, but that has a process in place to audit the payment posting and ensure every claim is followed through like Procare RCM.
- Help Recover Revenue
- Accurate Denial Tracking and Management
- Consistent Follow Up on All Claims
- Experts in Accounts Receivable (AR) Recovery
REIMBURSEMENTS
Posting payments, adjustments, recoupments, denial code management, appeals, and consistent follow up ensure reimbursements are accurate. According to the MGMA and other resources, 50-60% of denials are never followed up on and reworking just one claim can cost a medical practice $25.00. Whether your staff is not following up on denials or has to rework them, this could still be affecting your bottom line.
Procare RCM has proven processes in place so you can rest easy that our teams are working tirelessly to ensure that every claim is paid as quickly as possible. We offer custom packages and full end-to-end medical billing services that will streamline workflows, increase revenue, and free you up to focus on your business.