Back-End Revenue Cycle Management

Back-End Revenue Cycle Management

  • Back-End revenue cycle services have been very vital parts of the Healthcare firm’s financial functions with a lot of concentration on accounts receivables, dealing mostly with claims processing, handling processes of reimbursement, and collection of revenues.

    Back-End revenue cycle services covers activities that involve processing of claims, management of reimbursements, and ensuring timely collection of dues outstanding after patient encounters. One of the important activities in connection with these services is Accounts Receivable management, with major goals of maximizing cash flow and minimizing outstanding balances.

Our Services

Claims Submission and Processing:

  • Reviews denied claims and resubmits them to the insurance Payor's accurately within the timely filing limit.
  • Follow up on all claim statuses effectively through follow-up calls so that they should get reimbursed at the right time.

Denial Management:

  • Investigate and appeal claim denials to ensure maximum reimbursement and reduce possible lost revenue.
  • Students will take measures to prevent future denials by addressing areas in documentation and coding practices.

Payment Posting and Reconciliation:

  • Post payment received from payor and patients against billed charges.
  • He will correctly identify and correct discrepancies to ensure accurate financial records and reporting.

Aging AR Management:

  • Monitoring of aging accounts receivable and manage accordingly to manage priorities with escalations of collection efforts when necessary.
  • Developing and implementing efficient strategies to bring down days in AR and improve cash flow.

Financial Reporting and Analysis:

  • Prepare reports for financial decision-making on revenue performance, AR aging, and key performance indicators.
  • Trend analysis; process and revenue enhancement recommendations.

Benefits

Improved Cash Flow: Faster and more efficient processing of claims and management of AR results in the fast-tracking of revenue inflows to improve the stability of cash flow.

Reduced AR Days and DSO: Proper follow-up of outstanding claims and their resolution guidelines help bring down Accounts Receivable days and Days Sales Outstanding.

Revenue Leakage Reduced: Proactive denials management and appeals bring down losses due to denials and underpayments from claimed revenues.

Increased Operational Efficiency: Streamlining of back-End processes frees resources and optimizes staff productivity towards spending on core business activities.

Enhanced Financial Performance: Revenue cycle management optimization raises overall financial performance by capturing each revenue dollar.

Compliance and Risk Mitigation: Trailing off compliance risks and potential penalties by ensuring conformity with the set regulatory requirements and Payor guidelines.

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