Revenue Cycle Management Hospitals

RCM Cloud: The Web-Based, End-to-End Revenue Cycle Management Solution

Overview


The RCM Cloud® “software as a service” (SaaS) model strives to replace resource-intensive medical billing processes with digital solutions that reduce manual processes and optimize workflow thru automation.  This approach significantly improves operational efficiency and further allows the business to expand service delivery capacity with only minor increases in administrative staff.  Leverage your investment in technology to grow and sustain your business as opposed to increasing the headcount necessary to expand.

On the administrative side, RCM Cloud® and associated services are delivered via the powerful, proven and secure Medsphere Cloud Services platform. RCM Cloud® modules include Patient/Resource Scheduling, Enterprise Registration, in-stream Payer Eligibility Checking, Contract Management, Medical Records, Billing, Claims, Payer and Self-pay Collections, POS Payment Posting and Bad Debt which enable all types of healthcare entities to truly transform their revenue cycles.

Thanks to the Collector Work Schedule tool, we have not only decreased our overall AR days, but have improved our ability to support the mission and values of the organization... We place the patient at the center of our design and decisions.

Linda Hocker, Director, Business Office and Registration

Oklahoma Heart Hospital

The RCM Cloud® key financial objectives:

  • Streamline the entire patient access process from scheduling to registration to discharge to billing
  • Accelerate accounts receivable payment collections
  • Perform real-time payer eligibility checks during scheduling and/or registration
  • Integrate payer rules and enforce financial accountability
  • Reduce billing delays and denials
  • Significantly improve clean claims rates
  • Eliminate dependencies on and the associated costs of third party “bolt-ons”
  • Get real-time information when and where it is needed
  • Accurately measure organizational productivity and performance via dynamic scorecards
  • Leverage RCM Cloud® Dashboards that empower you to quickly improve performance across all aspects of your revenue cycle

A Complete Solution for Hospital Administration


Functionally, RCM Cloud® is an all-inclusive suite of patient access and revenue cycle components that can replace any existing HIS and its’ add-on applications. The solution is all browser-based and easy to use. The following is a sample of the look and feel and functionality found within RCM Cloud®:

Application


Enterprise Patient/Resource Scheduling

Enterprise Patient/Resource Scheduling features a unique drag-n-drop user interface.  Users can create their own views of their schedules. The module includes; conflict checking, reservation generation, waitlist tracking, same-session multi-departmental scheduling, medical necessity checking, recurring and group scheduling, synchronization of a resources schedule with Outlook Calendar and much more. Enterprise Patient/Resource Scheduling is the coordinator for patients and resources to promote effective and timely scheduling of services and procedures across the enterprise. Resources can be a provider, staff, room and equipment. Overbooking is supported.

Application


Enterprise-wide Patient Registration

Enterprise-wide Patient Registration addresses the needs of acute care, behavioral health, ambulatory, emergency, urgent care and specialized healthcare facilities. The solution includes a number of dynamic work queues to assist users in their workflow. An unlimited number of “registration edits” can be setup to address demographic and financial content to be collected. The system provides a complete sub-module for Census Management/ADT needs. Further, patient registration includes; in-stream payer eligibility checking, POS payment entry, authorization processing, medical necessity checking/ABN generation and optional propensity-to-pay and identification verification. We meet all of the mandated CMS regulations regarding Medicare secondary payer questionnaire.

Application


Medical Record Abstraction

Abstraction determines the final status of a patient’s encounter based on evidentiary support within the medical record. Abstracting includes assigning and validating diagnosis and treatment codes in order to confirm the accuracy of the record and achieve optimum claims submission and reimbursement results.

Application


Patient Accounting

Patient Accounting provides a sophisticated, comprehensive universal (inpatient and outpatient) billing solution, which includes contract management, interim-episodic billing, integrated claims resolution, denials tracking and more that is uniquely engineered to maintain accurate control of all financial data while allowing the flexibility to streamline user tasks.

Application


Payer and Self Pay Collections

The Payer and Self Pay Collections module provides a host of tightly integrated capabilities, which include an on-line tickler file system, user-defined actions for follow-up, e-statement processing, patient payment portal,  online audit trail, auto secondary payer billing, collector productivity scorecards and a vast catalog of real-time, drill-down reports.

Application


Informatics

The Informatics application features a full array of leading-edge business intelligence executive dashboards, dynamic work lists and reports that enable key decision makers at hospitals and other healthcare organizations to easily and effectively analyze and act upon crucial patient service and financial data. Informatics allows users to seamlessly collect and view key statistical and trending data to make the business decisions necessary to ensure continued success.

Application


Microsoft Dynamics 365 Business Central

As needed, Microsoft Dynamics® 365 Business Central suite can be bundled to provide financial management, human resources, and payroll solutions. It is a fully integrated business management solution that can significantly improve the financial and business processes of healthcare organizations.

Additional Benefits


Improve Cash Collections

Optimize Staff Productivity

Reduce Bolt-on Applications

Combine Medsphere Solutions

When you bundle with the other Medsphere solutions, not only do you get a one-stop partner to help you succeed, but your organization becomes even more efficient with completely integrated solutions. From hospitals to physician practices, Medsphere can be your go-to resource for all your Health IT needs.

Product

CareVue

Service

HIT Consulting

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