Revenue Cycle Management

We provide a strong billing experience based on our state-of-the-art software. Our healthcare revenue cycle management services provide consulting and outsourcing for physician and medical billing, collections and claims using our innovative, top-of-the-line software.

The typical revenue cycle technology still consists of numerous stand-alone software applications and databases pieced together through a complex web of legacy and home-grown interfaces and manual processes. Initiatives to streamline and modernize process flows and data analytics capabilities are further complicated and limited because revenue cycle systems are historically distinct from clinical systems and lack standard data models for sharing health information between payers (users), providers and patients. Although providers spend approximately $6.7b a year on revenue cycle management (RCM) solutions,an estimated 15%-20% of nominal billing value of claims submitted, are typically denied, a vast majority of which are due to technical or authorization reasons that can be addressed through more integrated systems. At the same time, payer (both government and commercial) scrutiny on compliance and audit of charges continues to be high, requiring enhanced tracking and management capabilities in the RCM function.

Now, in response of changing world requirements, our Aptuso software supply improving financial performance and enhancing the patient experience, while delivering efficiencies and reducing the overall cost of the revenue cycle. In the center of our service is a combination of 4 core values: optimizing the RCM technology environment; adopting advanced analytics techniques; improving payer connectivity and enhancing the patient experience.

  1. Оptimizing the RCM technology environment - An integrated system not only requires connecting the EHR with the RCM system (i.e., connecting the clinical and the financial data), but also enhancing operational capabilities of the RCM and streamlining the clinical and financial systems for greater insights into treatments, costs and outcomes.
  2. Аdopting advanced analytics techniques – this value include following services:
    - Tools to reduce bad debt write-offs and days receivables outstanding (DRO)
    - Proactive denials management
    • Predictive analytics and business intelligence
  3. Improving payer connectivity - enhancing communication between providers and payers may be the most critical aspect of a successful RCM development. This value, we achieve by:
    • Deployment of EHR/RCM platform optimized for value-based care
    • Single platform for claims management and adjudication
    • Real-time adjudication
  4. Enhancing the patient experience – all health-care providers need to make improvements that enhance the overall patient experience, particularly in those areas most visible to patients. We assure this need by:
    • Development of platform for feamless patient access
    • Providing of transparent pricing for single or combined services and patient estimates
    • Enhancement of financial assistance and counsel
    • Developing of patient financing program