Healthcare Revenue Cycle Management

Providing End to End Solution for you Healthcare Revenue Cycle Management.

We provide following critical services,among other, to provide an efficient revenue cycle solution to our clients.

• Eligibility Verification

  Prior to service being rendered by the provider, we verify the patient's current insurance eligibility, update the patient's account with current insurance eligibility status, and red flag any issues.

• Benefits verification

  Prior to service being rendered by the provider, we verify the patient's current insurance eligibility, update the patient's account with current insurance eligibility status, and red flag any issues.

• Authorization

  We initiate and aggressively follow-up on pre-authorizations with payers wherever required to ensure that clients can deliver their services to patients without fear of non-payment.

• Charge posting

  We follow a rigorous process of scrubbing claims during the charge posting process oriented towards maximizing first-time payments from insurers and minimizing denials.

• Payment posting

  Insurance payments are posted to patient accounts from the EOB. All payments received will be posted within 24 hrs.

  For payers who do not have Electronic Remittance (ERA), our team manually posts the insurance payments into the patient's account matching the respective allowed amount for each charge.

  To ensure that all payments received are posted, we compare bank deposits with the total payment posted in the PMS.

  If the patient has co-insurance, the remaining unpaid charges will be filed to the secondary insurance as per the coordination of benefits.

  Any deductibles, copays, Out-of-Pocket, and other patient responsibility stated by the insurance will be billed to the patient when the statements are generated. Before generating statements, we ensure that the patient account balance is correct and they are not billed for balances for which they are not liable. Patients' statements are generated on a monthly basis

• Denials management

  All denied claims are analyzed, corrected, and re-submitted within two working days upon receipt of the EOBs

• A/R management

  Our Accounts Receivable team compares expected and actual collections, understands the cause for discrepancies, and takes corrective measures to recover the difference.

  Inforaam systematic and regulated processes during each phase of the revenue cycle allow our AR team to keep Days in AR to below 30

  An initial analysis of old outstanding receivables will be performed whenever a new client joins Inforaam, and corrective action will be taken to recover as much revenue as possible from claims filed prior to the client joining Inforaam.

  Unpaid claims are processed using a prioritization based method, with high value claims and claims approaching the insurance timely filing limits given top priority.

  Any underpayment in the contracted amount or reimbursement rate of the insurance company will also be flagged and corrective action undertaken

• Claims management

  All claims will be generated and filed either electronically or via paper as per payer standards. The acknowledgement of receipt of the claims by the insurer is checked to prevent any loss of claims.

  Any potential errors resulting from the transmission either at the gateway or at the insurance clearinghouse will be resolved and resent within 24 hours barring clinical discrepancies.