Mid-End Revenue Cycle Management

Mid-End Revenue Cycle Management

  • Mid-End revenue cycle services concentrate on clinical documentation and coding processes for proper and timely Healthcare reimbursement. Activities covered under such services range from patient encounter documentation to coding and charge capture, thus forming a base for successful revenue cycle management.

Our Services

Clinical Documentation Improvement (CDI)

  • Reviewing and enhancing clinical documentation for accuracy, completeness, and specificity.
  • Educating Healthcare providers on the best practices of documentation that support correct code assignment.

Medical Coding and Reviewing Clinical Documents

  • Accurate diagnostic and procedural coding from clinical documentation based on ICD-10, CPT, HCPCS.
  • Ensure adherence to the coding guidelines and regulatory requirements for contact, thereby reducing claim denials, and fill all care gap requirement specifications per the CMS requirement.
  • Review of clinical documentation for the purpose of validating the accuracy and completeness of diagnoses and procedures
  • Documented services must support the medical necessity of the services rendered, as well as compliance with the guidelines of the related payor.

Charge Entry & Cash Posting

  • Accurately capture and enter charges for services rendered during visits.
  • Ensure all services are appropriately billed to maximize revenue, reduce billing errors and subsequent claim denials, reducing the financial pressures on the practice; also enhance the accuracy of records for finance purposes.

Compliance Monitoring and Education

  • Monitor the coding and documentation for compliance with regulatory requirements and Payor policies.
  • Provide education and training to Healthcare providers and staff regarding updates on coding changes and best practices.

Benefits

Optimized Revenue Capture: Improved  accuracy in documentation, coding and charge capture leads to maximized revenue for Hospitals.

Reduced Claim Denials: Improved clinical documentation with accurate coding reduces the claim denial rate and reduces delay in reimbursement.

Improved Cash Flow: Streamlined mid-revenue cycle processes accelerate the billing and reimbursement cycle to keep pace and improve cash flow management.

Improved Data Accuracy: Reliable clinical documentation and coding ensure data integrity and support informed decision-making in Healthcare delivery.

Compliance and Risk Mitigation: Following source code and regulatory standards reduces audit risks and associated financial penalties.

Operational Efficiency: Smooth mid-revenue cycle operations free resources to focus more on the delivery of care by Healthcare providers.

Patient Satisfaction: Accurate billing and less financial dispute raise patient experience and satisfaction.

Have any Question? Ask us anything, we’d love to answer!

+1 703-348-2793