Revenue Cycle Management



Revenue Cycle Management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.

RCM unifies the business and clinical sides of healthcare by coupling administrative data, such as a patient's name, insurance provider, and other personal information, with the treatment a patient receives and their healthcare data.

Communicating with health insurance companies is a key component of RCM...

Here is what's involved in the revenue cycle:

  1. Charge capture: Rendering medical services into billable charges.
  2. Claim submission: Submitting claims of billable fees to insurance companies.
  3. Coding: Properly coding diagnoses and procedures.
  4. Patient collections: Determining patient balances and collecting payments.
  5. Preregistration: Collecting preregistration information, such as insurance coverage, before a patient arrives for inpatient or outpatient procedures.
  6. Registration: Collecting subsequent patient information during registration to establish a medical record number and meet various regulatory, financial, and clinical requirements.
  7. Remittance processing: Applying or rejecting payments through remittance processing.
  8. Third-party follow-up: Collecting payments from third-party insurers.
  9. Utilization review: Examining the necessity of medical services.
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Revenue Cycle

The revenue cycle includes all the administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue, according to the Healthcare Financial Management Association (HFMA).

Medical Billing



Changing healthcare reforms by the government to eventually improve the quality of healthcare is currently causing havoc to various healthcare practitioners’ revenue management with new challenges like - increase in denials and operating costs, reduced reimbursements, reduced amount of time spent on patient care due to increased administrative tasks and more intricate coding.


With various medical reforms to be effective very soon like the Affordable Care Organization Concept, the Sustainable Growth Rate (SGR), the mandatory transition to exhaustive ICD-10 and HIPAA 5010 medical coding and reporting compliance, the revised ABN (Advanced Beneficiary Notice of Non-coverage), Form CMS-R-131 and so on – An experienced billing service will definitely help provide your healthcare practice a competitive edge!

Maggnessa provides customized patient scheduling and registration process that works the way you want it to work by providing:

    Personalized schedule templates and appointment types:

  1. User-defined schedule views – by appointment type, location or provider.

  2. Customizable welcome email for new patients.

  3. Automated phone and email appointment reminders and confirmations.
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Patient Registration


Medical Coding



Maggnessa has put in place an expert team of highly credentialed and experienced coders. All our coders are AAPC certified, have a minimum of five years of experience and are continually working to stay on top of latest changes in the industry. Leveraging this vast repository of expertise:

  1. Offshore coding audits
  2. HCC medical coding
  3. HCPCS, ICD-9 and ICD-10 coding including ICD-10-CM, ICD-10-AM, ICD-9-CM and CPT-4 medical coding
  4. Payer specific coding services
  5. Chart Audits and Code Reviews

Accurate-Coding

Inaccurate Coding Not Only Increases The Claim Denials But Also Impacts The Patient Satisfaction. Our Highly Trained And Experienced Coders Use Their Expertise And Knowledge Of International Coding Standards To Translate The Services Provided To A Billable Item Accurately At The First Attempt Itself.

Standardized Pre-Protocol Approvals

Using Our Standardized Tools And Techniques, Our coders can meet all your coding needs, with expertise in ICD-10, CPT4/HCPCS, MS-DRG, and more. We Help You Determine The Eligibility Of A Patient For The Billed Services. This Reduces The Probability Of Claim Denials And Ensures An Early Reimbursement.

Coding

Medical Coding

Time Bound And Accurate Billing

We Take Care Of The Tedious Process Of Submitting And Follow-Up’s On Claims So That You Can Focus On Your Core Job. Our coders are all highly-trained and experienced so you Can Improve The Efficiency Of Your Billing Cycle By Identifying Potential Errors That May Lead To Denial And Ensuring Timely Submission Of All The Claims. We offer 24-hour turnaround time.