Our RCM solution suite is uniquely customized to improve your profits and relieve you of the pressures of hiring, training and motivating ineffective employees. Our RCM Solution Suite include following services -

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-Scheduling-

Centralized Patient Appointment Scheduling improves the quality and accuracy of collected data. Increasing the number of confirmed appointments and reducing the number of ‘no shows’.

-Eligibility Verification-

Insurance Eligibility Verification allows for eligibility checks and corrections to patient accounts, in turn ensuring that only the most correct and up-to-date information is entered into the system prior to the patient’s arrival. Doing away with such a time-consuming task offers front desk staff the opportunity to focus on other pre-visit tasks such as co-pay/consent collection, financial counseling of patients and setting up follow-up appointments. This leads to decreased eligibility denials, thus enhancing patient satisfaction and increasing revenue margins.

-Pre-certification-

The Pre-certification Solution provides prior authorization for services that are performed and obtained by Hexa on behalf of the client. This implies decreased man hours, greater accuracy and a faster turnaround time – ensuring that you now have all the necessary payor authorizations; leading to an increased assurance of proper and complete payments.

-Coding-

Healthcare revenue is increasingly being driven by correctly coded services. Therefore, taking in to account spiraling costs and a lack of trained coders in the industry, we eliminate hiring and retention expenses by providing fully-trained and certified coders. Regular audits and knowledge up gradation ensure maximum quality, which in turn improves billing and eventually leads to increased revenue.

-Charge Capture-

The Charge Entry Solution provides for manually charged entries of already coded services into a client’s billing software via remote log in. Educated and well-trained staff ensures that there are minimal key-in errors, thus maximizing cash flows and allowing client staff to devote extra time to the provision of more value-added services.

-Billing-

The Billing Solution provides for both – the generation and the submission of clean, scrubbed claims to the payors. This includes processing for both, electronic and paper claims. Customized editing helps identify and rectify issues prior to the submission of claims, leading to the increased submission of clean claims, resulting in quicker payments. In short, we help accelerate the client’s cash flow.

Payment Review & Posting
A team of highly skilled and analytical staff enables the timely and accurate posting of all payments, correspondence and contractual adjustments, allowing for the efficient use of AR and follow-up staff.

-Denial Management-

A Denial Management team provides an insight into the types of denials a client receives, the appropriateness of these denials, and the best way to achieve resolution and payment. A team is also put into place to enable the timely filing of appeals, obtaining and submitting medical necessities and also initiating effective tracking and trending of denials. This system helps draw up denial prevention strategies, apart from resolving denials at lower administration costs.

-AR Management-

An AR follow-up team organizes patient accounts that have not yet been paid – to provide a targeted and appropriate follow-up based on age, dollar amount, and type of service availed of by the account. The goal is to maximize the effect of the follow-up in order to obtain correct and timely payments. A highly trained, flexible work force enables consistent, efficient and cost-effective collections of all deserved collectibles, while state-of-the-art account reporting and analytics leads to a drastic reduction in AR aging days and a dramatic increase in cash collections.