Revenue Cycle Management
Revenue cycle management (RCM) is the financial process, involving patient care episodes from registration, appointment scheduling, and claim processing to the final payment of a balance. In the modern days, RCM process is implemented efficiently by using software.
Enoque’s Revenue Cycle Management
What we offer
Revenue cycle management (RCM) is the financial process, involving patient care episodes from registration, appointment scheduling, and claim processing to the final payment of a balance. In the modern days, RCM process is implemented efficiently by using software. Front office is the foundation for the entire revenue cycle management process across all functional areas any error leads to financial loss. Thus, we provide capacity building to our clients.
Precise and comprehensive clinical documentation, coding and charging practices across the hospital and physician practice spectrum are captured in the middle of the revenue cycle. Error free documenting a patient’s care at middle of revenue cycle management improve outcomes in the revenue cycle down the line. Clinical Documentation creates a thorough record of the symptoms, medical history, diagnosis made, treatment procedure planned and executed, care provided, the outcome of treatment and clinical assessment of the entire treatment process. As a rule of thumb, “If Procedure isn’t documented, it didn’t happen” and payment will not be made.
The integrity of Clinical Documentation and quality of the documentation is reviewed to confirm that it reflects the severity of illness and the intensity of services rendered. This step helps to ensure that the coding process results in appropriate reimbursement. It should be noted that accuracy of diagnostic or procedural coding is based on the provider’s documentation and involves ICD, CPT, ACHI, Pharmacy and other acceptable coding.
The last and ultimate goal of the revenue cycle is to receive timely and appropriate payment for services rendered. Claims Management tools can help speed the submission of claims by automating edits to increase clean claim rates.
Enqoue RCM services is based on concept of Patient to Payment system. We are engaged in Quality claim documentation, clinical coding, medical and technical review of claims, case management, contract management, denial management, payment processing along with benchmarking.
Enoque RCM’s Patient-to-Payment approach addresses the challenges through a comprehensive set of competencies that come together holistically, helping to solve business problems of provider across the entire spectrum of the revenue cycle. These skill sets include a range of solutions, from revenue cycle software, strategic outsourcing, advisory services, analytics and capacity building.
our Patient-to-Payment approach leverages these skills based on individual client needs, diagnosing business issues and their root causes, followed by implementation of customized, integrated solutions that include one or more solutions to holistically transform the revenue cycle of Hospital. Our implementation for every client is unique, with some spanning our full Patient-to-Payment offering and including a combination of analytics, technology and services.