Revenue Cycle Management

Focus only on Medical Care...

Sharp Info Solutions understands the criticality of financial management and the consequence of great work. Revenue cycle management involves various tasks, processes, and procedures from the time a patient account is created to the time money is collected.

As a revenue cycle management company, we understand that the core job of the provider is patient care and not office administration. However, we also understand the criticality of ensuring optimal revenues to the provider.

Therefore, Sharp Info Solutions meticulously manages end-to-end revenue cycle management to maximize collections. Beginning from Insurance Verification to Payment Posting, every job is handled proficiently by highly experienced staff. We are certain that our clients are assured and are relaxed.

Enrollment and Credentialing:

Payor enrollment is a time-consuming process where attention to detail is critical and even the slightest mistake in an application can cause the entire process to halt which ultimately leads to delayed payments. We complete all applications and necessary paperwork on your behalf with the chosen Payor networks and government entities. Follow all Payor contracts through to contract load date and provide a copy of fully executed contract and fee schedules to your Practice or Billing Company.

Eligibility and Benefits Verification:

Eligibility / Benefits verification is a critical process in overall revenue cycle management. Eligibility verification is an efficient way to eliminate denials. Our team runs through a standard and customized list of verification questions to confirm the patient’s eligibility and coverage for the services to be provided. We will be able to predict the outcome of the claim, even before it is submitted.

Demographics and Charge entry:

Charge entry is done electronically to shorten the revenue cycle days. Patient demographics and medical codes applied to charts are appropriately verified. Every claim is verified to reduce the chance of claim rejection. Fee schedule of our clients is taken into consideration and bills are raised accordingly.

Claims are submitted to clearing house to ensure 100% accuracy. Our billers apply multiple layers of quality checks before submission of claims. We ensure clean claims submission.

Medical Coding:

Our medical coding services help our clients reduce their denials and optimize their revenues. Our professional coders are well experienced in procedural and diagnostic coding. Our medical coding services are compliant with various guidelines and help our clients stay focused on their core activities. We clearly understand the liability issues associated with incorrect coding and we thrive on high quality delivery.

We assist our clients with their short-term and long-term coding assignments. We are well prepared to face the challenges related to transitions in coding.

Payment posting:

Due to the sensitivity of payment posting process, accurate and efficient payment posting is inevitable for Physicians’ office. EOBs are not our bible. We thoroughly crosscheck the EOB’s and we verify it by adjudicating it ourselves. Our billers are known to be highly efficient and analytical in payment posting.

Their specialty lies in working on the most advanced electronic remittance scenarios such as:

  • Denials
  • Underpayments
  • Overpayments
  • Multiple Adjustments
  • Automatic Cross-over
  • Secondary Remittance
  • Reversals and more…

Before our biller closes the payment posting, they match patient payments accepted in the front-office to encounters entered in the back-office.

Denial Management & Appeals:

Denials are an epidemic to the financial health of most practices, and they have a need to be treated well in order to get you financial success. Around 10% of the physician revenue is estimated to be lost due to lack of denial management.

Billers in Sharp Info Solutions are experts in denial management. We believe in ensuring we have very less denials in the first place, and we deal with them efficiently when we have them…

Analysis:

The key to denial management is ANALYSIS. Once the root cause of a denial is figured out, correcting it and getting paid for it is not as difficult. The skill of a specialist is required to get the perfect analysis into the claim and Sharp Info is very good at it.

Appeals:

Our Billers review most commonly denied claims, prioritizing them based on both volume and dollar value and file them in a timely manner. Considering the cost of appealing claims both in terms of time and money, our billers have the wisdom to decide whether they must appeal. We know the fact that many practices lose great sums of income every year because they don’t appeal denied claims.

Accounts Receivable Management:

Account receivable is the vital part of any business. Our experienced callers use various follow-up methodologies to ensure prompt payments. We get to talk to the right person and get the claims resolved amicably.

Accuracy of the claim and the time spent on retrieving the payment are key points in optimized revenue collections. Reducing AR aging and maximizing cash flow is our goal.

Our billers have spent years on AR management. They have great understanding of claim status that they sometimes don’t even pick up the phone to follow up. They have the process knowledge at their fingertips!

Financial Management Reporting:

We customize reports according to our clients’ requirements. We present periodic financial reports and other reports that include information on claims filed, payments received, receivables, and aging. We can also customize our services as per client’s requirements, if the client does not wish to outsource the complete RCM. Our billers can take care of end to end Medical Billing requirements and can also support whenever the practice is overloaded.

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