Revenue Cycle Management (RCM)

Revenue Cycle Management (RCM)

TSI Healthcare’s® Revenue Cycle Management places the power of a full-service billing company at your fingertips. Our team of billing experts can help practices manage billing, improve financial performance, and eliminate headaches so you can focus on revenue-generating tasks.

Most importantly, our personal service and relationship offer a “high-tech, high-touch” approach to RCM. Our full-cycle RCM process includes tasks that often get pushed back onto the practice by many other RCM companies.

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Our Revenue Cycle Advantage

Review

Your Account Concierge performs a thorough survey at the start of your project. We evaluate key metrics to find the potential gaps in your current processes.

Configure

Our on-site workflow studies provide your team with a customized implementation plan tailored to your practice needs.

Mend

We focus on improving your financial health by implementing new technology, improving staff efficiency, and addressing errors/denials.

Deliver

Through our 12 Step Billing Cycle, we improve your clean claim percentage, reduce days in A/R and, most importantly, boost your revenue.

Our 12 Step Billing Cycle

Charge Capture

Charge Capture

• Obtain charges at regular intervals
• Triple Clean Claims
1st review: Manual charge & code “scrubbing” verification using team’s coding training/experience

Charge Posting

Charge Posting

• Post charges automatically or manually (depending on EHR)
• Triple Clean Claims
2nd review: Automated charge & code “scrubbing” verification using NextGen rules engine

Claims Submission

Claims Submission

• Submit claims at regular intervals for payor delivery and processing

Clearinghouse Management

Clearinghouse Management

• Upload claims for processing
• Triple Clean Claims
3rd review: Automated charge & code “scrubbing” verification using EDI Clearinghouse rules engine

ERA Processing

ERA Processing

• Manual review of individual EOBs for underpayment
• Subsequent automated review using NextGen rules
• Resubmit for payment according to negotiated plan rates

Denial Management

Denial Management

• Analyze denied claims and resolve errors
• Resubmit for payment
• Track to define trends and create new Triple Clean Claims rules

Payor Payment Posting

Payor Payment Posting

• Balance payments and verify against charges for accuracy

Statement Processing

Statement Processing

• Deliver online and/or paper statements per practice preference
• Print, package, and mail statements on your behalf

Inbound Call Service

Inbound Call Service

• Answer patient billing questions
• Accept incoming pay-by-phone requests

Collection Letters

Collection Letters

• Send automated collection letters for unpaid balances per practice preference
• Print, package, and mail letters on your behalf

Month End Closing

Month End Closing

• Monthly delivery of individual reports & analytics
• Personal review of practice’s current financial health with your Account Concierge

Fee Schedule Reviews

Fee Schedule Reviews

• Assist with personalized fee-schedule analysis of payer allowable rates

Triple Clean Claims™

1

1st Review

Manual charge and code “scrubbing” using our team’s coding training/experience.
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2

2nd Review

Automated charge & code “scrubbing” using NextGen® rules engine. Any errors are manually reviewed by team members.
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3

3rd Review

Automated charge and code “scrubbing” using EDI Clearinghouse rules engine. Any errors are manually reviewed by team members. Front line pinging to catch payor eligibility.

Our Dedicated Team

Based in the U.S.A. includes

Account Concierge

Provides guidance to specialists and delivers the one-on-one attention you deserve.

Charge Entry Specialists

Capture and scrub charges to improve first time claim pass-through.

Payment Entry & Claims Resolution Specialists

Investigate and solve errors or denials.

Patient Customer Service Specialists

Provide direct support to your patients for all of their billing needs.

By The Numbers

Average years of experience per team member

Hours for average charge entry & payment posting turnaround

Greater than 98% first-time claims pass-through goal

Less than 28 days in A/R (varies by specialty)

According To The MGMA

Practices Using RCM Services:

59%

Obtained access to better
reporting and analytical tools

73%

Saw reduction in A/R days and
higher collection rates

59%

Experienced a decrease in
denied claims

Industry Leading Software

NextGen PM Features
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Multi-View Scheduling

Advanced Appointment Search

Autoflow Registration

Robust Reports Library

Background Business Processor

ICD-10 Ready

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Learn more about EPM

NextGen EHR Features
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Meaningful Use Certification

E-Prescribing

Automated Coding

Lab Module

Specialty-Specific Enhancements

Interoperability

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Learn more about EHR

EDI Clearinghouse Services
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Advanced Eligibility Verification

Connectivity With Over 1,800 Payers

Reduce Denials

Compliant With Government Regulations

Decrease Fraud and Bad Debt

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Learn more about EDI

  • "Our financial health experienced a tremendous improvement because of our partnership with TSI Healthcare's RCM team. Our clean claims rate jumped from 76% to 98% and our A/R decreased to 12 days."

    Mandeep, Office ManagerNew England Rheumatology

  • "We are extremely pleased with the services that TSI Healthcare RCM provides our office and are consistently impressed with their attitude and productivity. They always perform above and beyond with excellent customer service. They are a valuable asset to our organization.”

    Debbie, Office ManagerSalem Rheumatology

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