Revenue Cycle Management

Revenue Cycle Management

Codelab Claims offers expert Revenue Cycle Management (RCM) solutions, streamlining claims processing, maximizing revenue, and reducing administrative burdens.

Key Benefits

• Increased Revenue: Optimized claims processing and underpaid claim recovery.
• Faster Payments: Efficient insurance follow-up and settlement processes.
• Reduced Administrative Burden: Streamlined billing and claims management.
• Enhanced Patient Satisfaction: Seamless communication and billing.

Why Choose CODELAB CLAIMS for Revenue Cycle Management?

• 9+ Years of Expertise: Proven track record serving clinics, medical centers, hospitals, and labs.
• Flexible Solutions: Customized RCM services addressing unique client needs.
• Certified Specialists: Medical coding and billing experts ensuring accuracy.
• Comprehensive Services: Charge capture, denial management, claims submission, insurance follow-up, and accounts receivable management.
• Experienced Staff: Minimum 5 years of RCM experience.
• Cutting-Edge Technology: Up-to-date software ensuring efficient operations.
• Secure Outsourcing: Rigid information security procedures protecting sensitive data.
• Actionable Insights: Advanced analytics and reporting.

 

Benefits of Partnering with CODELAB CLAIMS

• Maximized Revenue: Optimized cash flow and reduced bad debt.
• Minimized Compliance Risks: Expert handling of regulatory requirements.
• Improved Patient Satisfaction: Streamlined billing and communication.
• Enhanced Productivity: Focus on core healthcare services.How CODELAB CLAIMS Revenue Cycle Management Process Works?

 

CODELAB CLAIMS Revenue Cycle Management Process

• Client Onboarding: Collaborative process understanding, expectation setting, and seamless transition.
• Customized Solution: Dynamic outsourcing model tailored to client-specific needs.
• Business Associate Agreement (BAA): Ensuring HIPAA compliance and data confidentiality.
• Service Level Agreement (SLA): Defining quality standards and performance metrics.
• Dedicated Account Executive: Single-point contact for communication and coordination.
• Secure Data Transfer: Encrypted file sharing and remote access.
• Training and Development: Staff training on client-specific processes and systems.
• Ongoing Support: Regular progress updates, reporting, and issue resolution.
• Continuous Improvement: Regular process evaluations and optimization.

Key Benefits

• Streamlined revenue cycle operations
• Enhanced cash flow
• Reduced administrative burdens
• Improved compliance
• Increased patient satisfaction

Business Associate Agreement & Service Level Agreement:

Confidentiality and Service Commitments.

Codelab Claims prioritizes data protection and service excellence through two critical agreements:

• Business Associate Agreement (BAA): Ensures compliance with HAAD, DHHS, and HIPAA regulations, safeguarding Protected Health Information (PHI) and maintaining confidentiality.
• Service Level Agreement (SLA): Defines quality standards, scope, and metrics for outsourcing services, aligning with client values and goals.

 

Additional Commitments

• Non-Compete Agreement: Protects client interests and intellectual property.
• Non-Solicitation Agreement: Preserves client relationships and talent.

Regulatory Compliance

Our agreements adhere to:

• HAAD Policy (UAE)
• HIPAA (USA)
• DHHS regulations (USA)

 

Partnership Benefits

• Enhanced data security
• Clear service expectations
• Collaborative relationships
• Confidence and trust

Account Executive Assigned – Key point of contact

​An experienced knowledgeable executive is assigned to every customer for handholding (handling) through the transition process and serves as a conduit between customer and the outsourced team. Once the services are established and active, the account executive will coordinate and communicate via phone or email at a customer defined frequency and/or as required by the customer.

​Secure Remote Access, File Transfer Systems, VPN Tunnels

​We will work with your IT support team to set up customer’s office computers and network for secure remote access as well as establish a file-transfer system for electronic transfer of files. In view of the sensitivity associated with the healthcare information all our teams work on fully locked down dumb terminal PC’s and have restricted remote access to customer’s software applications and tools required to accomplish the assigned job function in a secure manner.

Preliminary Training & Development

As we work on your software or system we always request some documentation on customer’s present process, training manuals for our teams to understand customer’s practice specifics and may schedule online meetings with customer’s current staff for better understanding of their processes. During this phase we would also request some demo accounts for our internal training and development.

​MIS Reporting Requirements

​We offer a variety of MIS reports & progress related reports based on customer needs however we can customize reports as per your requirements.

​Revenue cycle management benefits include

• Increased average % of claims paid after 1st submission
• Increased average % of current claims (0-60 Days)
• Reduced denial rate
• Improved net revenue to the practice
• Higher percentage of clean claims
• Reduced outstanding accounts receivables
• Faster claims payment
• Less lost claims
• Improved quality of care by having more time for patient care issues
• Correct patient information available and less stress to your staff

In order to achieve compliance, healthcare providers must employ software technology and a centralized billing/coding system. Incorporating revenue cycle management processes as part of an overall business strategy often results in improved reimbursement, accurate billing compliance and great clinical outcomes.Having a revenue cycle management partner can help healthcare clinics operate more efficiently and in turn provide greater medical services to those who need it the most.

Outsourced Medical Billing Services For

• Doctors
• Medical Groups
• Hospitals
• Independent Physician Practices (IPA)

Roles and Responsibilities : (which rules and responsibility are these comes under rcm in website)

The roles and responsibilities have to be defined by you beforehand. The intention in doing so is that we work as an extension of your office and no duplication of any efforts is done. All the redundant work is dropped and a fairly simple paperless process is created to streamline the operation. We handle the entire process for our customers leaving them to concentrate on their practice and patient care.

• Improved Product / Service
• Increased return on investment
• Reduced costs the tune of 35-60%
• No or little infrastructure requirements
• Improved customer service/satisfaction
• Resource Availability in sync with demand
• Effective deployment or better use of capital
• Taking advantage of latest & future technologies
• Increased management focus on core strategic issues
• Improve performance & process efficiency in critical areas
• Depth of process expertise, access to subject matter experts
• Reduction of risk in terms of technology and/or skilled personnel