ProHealth: Healthcare Revenue Cycle Management Solutions
Manage and Optimize All The Financial Aspects of Your Healthcare Practice with Revenue Cycle Management Software
Ensure Financial Stability and Comply with Regulatory Requirements
Our specialized healthcare revenue cycle management software solution can automate and streamline your medical billing needs and revenue streams while ensuring compliance and protecting your data. Register patients, process healthcare billing, and collect payments all from the same health system. Reduce errors and denials, prioritize access, and improve your healthcare organization’s workflows.
Claims Processing
Patient Registrations
Coding and Billing
Collection and Appeals
Optimize Your Streams With Healthcare Revenue Cycle Management Software
Improve efficiency, optimize revenue collection, and alleviate financial stress by keeping up with your cycle performance during all stages. Our leading revenue cycle management solutions can help healthcare providers with:
Our Revenue Cycle Management Solutions
Healthcare revenue cycle management services are critical for healthcare organizations. Here are some of the services we provide at Pronix Health:
Patient registration and eligibility verification
Our patient registration services aid in ensuring accurate and complete data registration for billing and reimbursement purposes. We offer assistance in collecting necessary patient information, verifying insurance eligibility and coverage, and ensuring smooth processing of collections.
Revenue cycle analytics and reporting
You will also be able to generate reports on key performance indicators (KPIs), such as denial rates, days in accounts receivable, and collection rates, with our system.
Charge capture and coding
We can accurately process and document the coding of the services provided by your healthcare organization, including the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) systems – both of which record patient procedures, diagnostics, diseases, and injuries.
Compliance and vendor management
We can guide you to ensure that your practice complies with federal, state, and local regulations that relate to billing, coding, and reimbursements and manage relationships with third-party vendors (for instance, billing and coding companies, revenue cycle software providers, and collection agencies).
Claims submission and follow-up
Our solutions simplify the process of submitting reimbursement claims to insurance companies and government programs, while also providing support for tracking and following up on claim status and payment – reducing the chance of claim denials, rejections, or lost revenues.
Denial and appeals management
As well as identifying claim denials, our healthcare billing and revenue cycle management solution can also help you resolve and appeal claims to ensure that providers are reimbursed for the services they rendered. Our solutions make it easy to find out the cause of denials, craft appeal letters, record key metrics to categorize reasons, and eliminate backlogs.
Payment posting and reconciliation
Our software for hospital revenue cycle management not only assists in recording and reconciling payments from insurance providers and patients but also facilitates swift resolution of any discrepancies that may arise.
Patient financial counseling
We will help you communicate financial responsibilities and options to your patients and provide guidance on how they can deal with insurance coverage, payment plans, and financial assistance programs.
Let Us Help You Through All The Steps of the Revenue Cycle
From end-to-end, our revenue cycle management solution can help you with:
ProHealth takes care of the entire process, from the patient’s first appointment all the way to collecting the final payment.
With Pronix Health, you can significantly reduce the number of billing errors, claims resubmissions, denied claims, and patient complaints and disputes, leading to a more streamlined and efficient revenue cycle management process.
Contact us today to learn more about our Revenue Cycle Management Solutions
FAQs
Frequently asked questions about revenue cycle management solutions.
Healthcare revenue cycle management (RCM) services are all about helping you manage and optimize all the aspects of your billing, claims, and collections. For example, these services can cover patient registration and eligibility verification, capture and code charges, do claim submissions and follow-up, deal with appeals and denial management, carry out payment reconciliations and posting, and use revenue analytics and reporting.
Managing proper coding and billing on your healthcare systems is essential to ensuring healthcare providers receive final payment for their services. Suppose, for instance, that there is an error in the billing process while trying to charge, capture, or collect patient payments. In that case, your medical practice might get underpaid or overpaid, which can have a negative impact on your financial stability (not to mention your patient experience might suffer, too).
Healthcare organizations must comply with various regulations, which also include coding and billing specifications. Our revenue cycle management system can help ensure you are following the latest legislation and avoid fines and even legal action.
The main difference between RCM and medical billing is that, while the first combines all the processes involved in managing a healthcare provider's revenue, the second is only restricted to the major components. RCM software is helpful for both outpatient and hospital settings, and companies all around the world use it to manage their finances.
Healthcare revenue cycle management solutions can address challenges such as denied claims, inefficient billing processes, coding errors, delayed reimbursements, and lack of financial transparency.
These solutions employ strategies like accurate coding, claim scrubbing, denial management, and efficient billing processes to minimize claim rejections, reduce payment delays, and improve cash flow for healthcare organizations.
Technology plays a crucial role in revenue cycle management by automating manual processes, integrating systems, providing real-time analytics, and facilitating efficient communication between healthcare providers and payers.
How can healthcare revenue cycle management solutions enhance patient satisfaction?
Revenue cycle management solutions assist healthcare organizations in adapting to evolving reimbursement models by providing analytics, reporting capabilities, and guidance to optimize revenue streams.