Healthcare Revenue Cycle Management
Touchstone’s healthcare industry experts have average over 20 years of industry experience primarily advising healthcare service providers on revenue cycle management and healthcare insurance providers with eligibility and claim adjudication and management systems.
Our engagement begins with understanding and analyzing the current processes as well as systems in place, identifying the problem areas and developing performance improvement strategies, if the need be- redesign and revamp the process, redefine the sub-processes, create KPIs for each of the following areas:
- Patient Access
- Case Management
- Service documentation
- Billing
- A/R Management
- Customer service
and their core processes – scheduling & pre-registration, registration and admission, charge capture & coding, billing, collections and CSA, denial management & follow-up.
After this the tasks are categorized into front-office and back-office tasks and assign KPIs to the relevant areas and implement the best tools and practices with two primary goals- optimizing efficiency and maximizing reimbursement.
Revenue cycle management (RCM) has a key role in addressing shifting industry practices in response to three major trends: real-time processing, consumer-driven health care, and changes in regulations and reimbursement structures.
Touchstone’s team of RCM experts is not only well conversant with industry standards like ICD9, ICD10, CPT codes, HL-7 interface engines, CMS-1500 and UP-92/ UB-04 forms, they also specialize in how to convert a high-cost, error prone claim management and collection process into a high-efficiency, high performance and patient centered revenue cycle management using the state-of-art technology, tools and best industry practices by combining people, processes, technology, metrics, culture and communication.