Revenue Cycle Management (RCM)

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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

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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.

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

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

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

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Our 12 Step Billing Cycle

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• Obtain charges at regular intervals
• Triple Clean Claims

1st review: Manual charge & code “scrubbing” verification using team’s coding training/experience

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

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• Submit claims at regular intervals for payor delivery and processing

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

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

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

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• Balance payments and verify against charges for accuracy

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

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

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

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

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

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Triple Clean Claims™

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Manual charge and code “scrubbing” using our team’s coding training/experience.
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Automated charge & code “scrubbing” using NextGen® rules engine. Any errors are manually reviewed by team members.
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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.

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Our Dedicated Team

Based in the U.S.A. includes

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

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

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Investigate and solve errors or denials.

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

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By The Numbers

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[sf_count from=”0″ to=”15″ speed=”2000″ refresh=”” textstyle=”h3″ subject=”Average years of experience per team member” prefix=”” suffix=”” commas=”false”]

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[sf_count from=”0″ to=”24″ speed=”3000″ refresh=”” textstyle=”h3″ subject=”Hours for average charge entry & payment posting turnaround” prefix=”” suffix=”” commas=”false”]

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[sf_count from=”0″ to=”98″ speed=”4000″ refresh=”” textstyle=”h3″ subject=”Greater than 98% first-time claims pass-through goal” prefix=”” suffix=”” commas=”false”]

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[sf_count from=”0″ to=”28″ speed=”5000″ refresh=”” textstyle=”h3″ subject=”Less than 28 days in A/R (varies by specialty)” prefix=”” suffix=”” commas=”false”]

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According To The MGMA

Practices Using RCM Services:

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Obtained access to better
reporting and analytical tools

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Saw reduction in A/R days and
higher collection rates

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Experienced a decrease in
denied claims

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Industry Leading Software

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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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NextGen EHR Features
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Meaningful Use Certification

E-Prescribing

Automated Coding

Lab Module

Specialty-Specific Enhancements

Interoperability

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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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Our unique partnerships with Availity, a national EDI clearinghouse leader, helps practices get the information they need every step of the way. TSI Healthcare’s direct integration with Availity ensures simplified connectivity, improved claim and payment process, and the platinum level support… All from one vendor: TSI Healthcare.

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