Still using an EMR that does not have a built-in RCM?

No More Entering the Same RCM Information Over and Over Again

1

With an RCM that is fully-integrated with its EMR, all information collected during patient intake to perform a verification of benefits will carry over to the EMR and RCM.

2

With non-integrated systems, the same information must be manually re-entered into multiple systems. This repetition of data entry is inefficient and can lead to errors.

3

Interfacing disparate systems can be costly and increases the possibility for interface errors as data is transferred from one software system to another.

4

Having a CRM, EMR, and RCM integrated into one database allows single-point data entry. The information seamlessly flows from patient intake to multiple points within the workflow for maximum accuracy, data integrity, and efficiency.

Ability to
Auto-generate
Charges

1

An integrated system auto-generates charges based on each unique patient from data it pulls from the EMR. With a non-integrated system, census information is typically handed over to the billing department and then is manually entered into the RCM.

2

An integrated system prevents billing errors, such as missing billable sessions or days of stay.

3

For outpatient services, charges are auto-generated based on attendance.

Easy-to-perform
Billing Audits

1

An EMR and RCM integrated in one database prevents missed billing opportunities and partially billed authorizations by ensuring that all billable items are accounted for and then actually billed.

2

A fully integrated EMR automatically feeds authorization numbers from Utilization Review to the RCM. System controls ensure that authorizations that do not match admission records are red-flagged when claims are submitted.

Easy-to-implement
Patient Billing

1

When it comes to patient billing, an integrated system reduces the issues that come from disparate software systems. Different systems for patient payments and insurance payments obscure a company’s full financial outlook and are inefficient. A fully-integrated EMR and RCM streamlines these processes and eliminates redundancies.

2

Generating patient account statements is no longer a manual process from disparate systems.

RCM Software Features

1 Process

Supports HL7 interface and can port demographics and insurance information from Lightning Step or other EMR systems

Claims are auto-generated in batches

Ability to bill both UB and 1500 claims

Claims are sent to insurance companies at rack or specified rate, and aging has the ability to reflect the contract rate.

Auto-set follow-up dates and send alerts to the billing team member for follow-up

Month-end close process confirms all charges and cash posted

Ability to detect payer reimbursement errors such as out-of-network reimbursement to in-network providers or facilities

Contains patient ledgers and can research all claims and payments concerning one given patient

Export to your GL software (such as QuickBooks) with changes to your GL accounts

Ability to configure specific billing requirements by payer and NPI

Payment posting flexibility

Maximum automation of cash receipts cycle by processing EFT payments from payers, receiving ERA files from payers, and parsing them into the patient ledgers to automatically post cash receipts.

2 Reports

Report on unbilled days out of EMR

AR Aging
I. Can run historical data that does not change
II. See summary and claim-by-claim data

Percentage of claims pushed to patient
I. Sort by insurance company by day, week, or month

Percentage of claims that are denied and by reason

Average attempts at filing a claim before it is paid

Number and percentage of claims with stale follow-up dates

Claims worked by representative by day/week

Average days to collect

Percentage of AR by bucket

Total claims billed in a monthly period

Other Features

Administrative role-based access restricts unauthorized personnel from viewing sensitive data

Portal for patient contribution collections and viewing statements

M. Portal for patient payments

Hello!

Login to your account