Introduction


US healthcare takes a while to embrace changes. But when it does, a few existing players are toppled from the market. The current transition to Value Based Care (VBC) is a wave that could have similar repercussions for those RCM solution providers that fail to adapt. Those that will survive will need to focus on the user experience they offer, automation of low value-adding activities, modern technologies that are faster, and data-derived intelligence that guides workflows – All that at lower costs! That is going to be the focus of all business leaders that see it coming.


“Mere automation isn’t the answer. With the right processes, it would make them faster for better results.
With inefficient processes, it’ll do the same, just yield terrible results, faster”

Challenges to Overcome... 

Maintenance Nightmare
Maintenance Nightmare

Legacy billing systems that are a Pandora’s box of delay in enhancements

Linear Labor Costs
Linear Labor Costs

More billers and AR staff required for every new customer on-boarded

Poor User Experience
Poor User Experience

Multiple clicks and data entry/push which wear the RCM staff down

Lack of Scalability
Lack of Scalability

Solutions suited to single billers, unable to service large-scale floor operations

Evolving Regulations
Evolving Regulations

Changing business models, state/federal/payer regulations requiring persistent systemic changes

Lost Revenues
Lost Revenues

Recoverable revenue lost, due to the lack of enough hands on deck

Flying Blind
Flying Blind

Lack of cognitive automatable intelligence resulting in hunch-based decisions

Rising Training Overheads
Rising Training Overheads

Staff attrition and recurring errors, which spike overhead costs

Avenues to overcome these challenges

There are multiple opportunities that come with RCM solutions, that capitalize on modern technologies. Below are areas where we can make headway for providers and payers.

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Pre-registration & Check-in
  • Eligibility
  • Authorizations 
  • Patient Demographics Entry 
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Billing
  • Medical Coding
  • Charge Entry
  • Electronic Claims Submission
  • COB
  • Patient Billing
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AR Management
  • Cash Posting
  • Follow-ups
  • Statement Management 
  • Denials & Appeals
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Analytics & Process Improvement 
  • Clean Claim Rate
  • AR Days
  • Denial Rate

How do we help you achieve these?

There is no silver bullet when it comes to RCM. These challenges have scaled up with time, it will take efforts to get past those as well. Here, however, are ways in which we can help you dismantle your problems to help you progress again.

Technology modernization of existing solutions to ease maintenance and introduce flexibility and speed 

Redefine & Uplift the User Experience while reengineering existing RCM workflows for better productivity 

Data engineering for accurate integration, better data governance and intuitive dashboards using self-service BI 

Build unintrusive surface solutions for automated orchestration of billing workflows

Agile response to changing rules, business models, regulations through a reconfiguration of the systems

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