
什么是医疗RCM外包?
Revenue management cycle is important to simplify administration for medical institutions, 特别是对于医院. 外包医疗保健公司, offers all-inclusive healthcare and medical services; starting from a pre-registration to scheduling of appointments, 包括医疗账单和编码.
These outsourcing companies successfully achieve HIPAA compliance 并通过ISO 27001和9001认证, 采用系统化的方法,确保对患者细节的保护,提高客户整体操作的有效性.
An incompetent system can have many unpleasant effects and negatively crash multiple types of aspects of a medical organization.
Those companies who have expertise in this domain of revenue management deliver quality and undertake swift reimbursement, 以及有更好的行政程序作为确定的结果.
Revenue Management Cycle Outsourcing Solutions
无论您是医疗服务提供者还是独立医生, a good service provider can enable you with its medical services and required support that will meet your precise healthcare needs.
外包将确保一个更现代化和负担得起的医疗账单程序, which will result in a decrease in the present write-offs, with a speed up revenue generation cycle and help in building an enhanced patient provider relationship.
The RCM services for the medical industry comprise of medical insurance claims processing solutions, 医疗账单和医疗编码, which mainly focus on the required data quality and information accuracy in the healthcare industry.
There are companies which provide advanced and affordable solutions to all the large scaled, medium scaled as well as small scaled global customers.
这些医疗服务提供者 assist in collecting payments on submitted claims; boost the revenue from low paid claims, 并持续跟进保险公司,以加快结算速度. In addition, they support with the medical billing and 编码.
与此同时,他们还提供完整的患者登记和资格验证,从一开始就简化了流程.
RCM Process :
病人登记
The service providers assist you in processing your patients' demographic data and information. They take care of all the data entry of the patients' individual and the required insurance details. 他们还核实和确认所需的医疗案例相关信息. 一旦这个过程完成,这些病人的登记就完成了.
申索生成和提交
这些companies can handle both electronic claims submissions and the required submission of paper claims. 他们经验丰富的团队组织福利解释(EOBs),并向授权的医疗保险公司提交所需的索赔.
Medical Coding
These outsourced companies work in agreement with timely restructured healthcare standards, as well as methodologies generated by CMS, AMA, 医疗保险承包商, federal organizations and medical societies.
Charge Capture
These outsourcing service provider companies have different teams to manage and process charges for numerous specialties. Only a good company having far-reaching experience in handling these stuffs should be hired for better results which include:
- 医疗保险和医疗补助服务
- 3rd party liability
- Better managed care
- 理想的供应商组织
- Guaranteed insurers
- 工人的赔偿
Payment Posting
These outsourcing service providers make sure swift and precise posting of all the required payments into the billing system. 这些提供者对所有已支付款项进行定期审计,这有助于减少不同类型医疗过程中产生的错误,同时捕获所需信息.
拒绝处理服务
These outsourcing companies can assist in the analysis, correction, 以及重新提交被拒绝的索赔. This procedure includes identifying denials by the utilization of revenue 编码 and the required CPT/HCPCS codes.
一旦完成, the different reasons for the denials are analyzed and a comprehensive denial management report is being made ready. 这个过程有助于有效地管理所有必需的索赔拒绝.
应收账款服务
这些公司可以帮助您确定需要跟踪的病人帐户,并采取必要的行动来收取未付或欠付的索赔.
Solutions for the medical industry additionally include:
- Detection of the grounds for claims denials
- 使用CPT和ICD-9编码
- 权利要求认证的检查
- A/R Collections
- 收费入口以及付款张贴
- 电荷的捕获和编码
- 后续的保险
- Management of denial
- 随访的患者
- 未决索赔的后续行动
- 付款和应收款的分析
- 定期和准确的报告
- All types of modifications and adjustments
- 支付的及时性,适用于不同的付款人
- Payer mix and the maintenance of credit balances
- Provider enrolment as well as credentialing
改进流程的月度报告
您的收入管理外包合作伙伴也可以支持您准备每月报告,以协助管理所需的现金流和提高盈利能力.
这考虑到与医院收入周期管理服务有关的所有报告,这些报告有助于改进面向医疗的流程.
优化现金流
An outsourcing service provider with long enough experience, 谁投资了资源和对行业的了解被证明是医疗保健业务增长的完美商业伙伴. You can get assistance in multiple ways by outsourcing medical revenue cycle management services to an outsourcing expert.
收入周期外包的好处
- 在不进行任何额外投资的情况下,获得训练有素的专业人员的全部访问权
- 在负担得起的外包工作费用上节省整体医疗运营成本
- 利用符合HIPAA的程序来改进收入收集
- 完全访问24 × 7服务,确保更快速的周转时间
- Carry out periodic follow-ups to boost payment collections
- 探索改进业务流程的精炼技术
保障资料的承诺
Outsourcing service providers who have achieved HIPAA compliance and who are ISO 27001 认证更好地保护您的数据. In fulfilment with these standards for data security, they have stringent protocols in place to uphold Protected Health Information (PHI) and other required business related data.
Precision of Output
In agreement with iso9001质量管理标准, these service providers strictly follow the finest and best practices for every step of the revenue cycle management procedure. 为顺利开展医疗行业相关工作,配备专业技术人员,并对其进行流程化培训. This makes sure that the outputs produced for your business are precise and conveyed within the precise deadline.
快速周转时间
This outsourcing service provider companies work with 24x7 operations offering your business with a time zone benefit. Outcomes are delivered to you as per your industry requirement, 这将确保你获得最佳的流程效率这比内部资源提供的更好.
必要的可伸缩性
这些类型的公司拥有最好的技术人才和方法资源,为外包给他们的医疗项目带来灵活性和定制化. They are equipped to scale up their available resources as per your healthcare related business needs. This will reduce the load of non-core work on your in-house team of medical and administrative human resources, 帮助他们专注于完成任务的关键职责.
区分的好处
您需要为您的所有医疗保健需求找到一个可靠的外包合作伙伴, 其中包括医疗记录索引, 医疗客户服务, medical billing, 与健康状况相关的数据输入, 应收账款管理和医疗保健相关索赔的端到端处理.
Leveraging expertise can further assist you with
- Improvement in the overall collection ratio
- Raise the required probability of payments
- 提高所需和涉及的收入
Key Takeaways
稳定的, 通过您的收入管理外包合作伙伴产生的可靠和可预测的结果,将使您的医疗业务从各个方面获得更大的前景,并提高所需的盈利能力.
您必须选择一个忠诚的外包合作伙伴,他可以与您的公司建立长期持久的关系,并提供必要和有效的医疗支持服务.
在选择合适的医疗服务外包合作伙伴时,具有与全球客户合作的广泛经验将是加分项,该合作伙伴可以提供完全的可靠性,并能更好地帮助您在医疗保健行业更成功地工作.
100家以上的医疗保健收入周期管理(RCM)公司名单
收益周期管理对于任何企业的战略都是必不可少的. These processes are only growing in importance in healthcare as every dollar is expected to stretch further than before. Here are 110 companies that provide revenue cycle management solutions specific to the healthcare industry.
他们有超过10年的医疗账单和编程经验, 一个获奖的软件, that expedites your reimbursements faster, whether you are a multi specialty group or a solo practitioner.
2. 3M健康信息系统 (Salt Lake City)
3. Accretive Health (芝加哥)
4. Acustream (Lafayette, Colo.)
Acustream's proprietary RevBuilder enterprise solution uses client hospital billing and/or professional billing data, facility specific rules (FSR's) and predictive 分析 to find reimbursable "never billed" charges. 不是一个收集工具, RevBuilder会在因各种原因而丢失的数据中发现美元. The business model is 100 percent contingency-based.
5. Adreima (Downers Grove, Ill.)
6. 情景医疗解决方案 (Lombard, Ill.)
7. 顾问委员会公司 (Washington, D.C.)
8. AGS Health (New York)
9. Allscripts (芝加哥)
The company has a 99 percent net collections rate, 98 percent first pass clean claims rates and a 5 percent average increase in collections. Allscripts收入套件和服务提供预索赔解决方案, claims submission, inbound processing, A/R管理等等.
10. 阿尔瓦雷斯 & 马歇尔 (New York)
11. AmkaiSolutions (New York)
12. Anthelio医疗解决方案 (达拉斯)
The company offers IT services, 电子健康档案 and optimization services and its Pyramid HALO RCM services. Anthelio acquired RCM company Pyramid Healthcare Solutions in July 2015 to expand its revenue cycle offerings. 公司的RCM投资组合包括HIM外包和优化, medical 编码, 编码审核和教育, 收益评估和分析, 病人的金融服务, 临床文档的改进, 转录和语音识别, ICD-10支持和更多.
13. athenahealth (Watertown, Mass.).
14. Availity (Jacksonville, Fla.).
该公司的收入周期解决方案解决了患者访问问题, as well as the full spectrum of revenue cycle functions. 该公司还提供附加模块,从高级索赔编辑和比较分析到自付资格验证和工人补偿.
15. 美银美林 (Charlotte, N.C.)
16. BESLER Consulting (Princeton, N.J.)
17. 大胆的医疗解决方案 (Louisville, Ky.)
18. The Camden Group (El Segundo, Calif.)
19. Cardon Outreach (林地、德州)
20. CareCloud (迈阿密)
21. 欧洲核子研究中心 (Kansas City, Mo.)
In addition to its core revenue management solutions, 该公司提供计费和编码服务,包括收费处理, A/R follow up, 资格检查, denials management, cash posting, self-pay and early out as well as full 业务办公室的管理 for acute and ambulatory venues.
22. 改变医疗保健(纳什维尔,田纳西州.)
23. Citadel外包集团 (亨德森,田纳西州.)
24. 花旗的健康理财(纽约)



Money2 for Health关注的是收入周期中的患者支付流程功能. This service from Citi Group allows patients to pay healthcare bills easily by linking to checking accounts, health savings accounts and flexible spending accounts. The platform was launched in 2013 in partnership with Aetna and Parallon, a subsidiary of HCA.
25. The Claro Group (芝加哥)
26. Coker Group (Alpharetta, Ga.)
The firm also offers healthcare-specific revenue cycle support including revenue cycle staffing, pay mix analysis, 国家基准, 流程审查等.
27. 针叶树健康解决方案 (Frisco, Texas)
28. Connance (Waltham, Mass.)
29. Convergent (亚特兰大)
30. The Corridor Group (Overland Park, Kan.)
31. Craneware (亚特兰大)
32. Crowe Horwath (芝加哥)
Crowe Horwath is a public account, consulting and technology firm serving multiple industries. The firm's healthcare division offers finance, revenue cycle, reimbursement, 税, risk and compliance, audit and mergers and acquisitions services. Crow Horwath公司的收入周期管理项目包括信用余额管理, denials management, observations services and outpatient charge capture.
33. 戴尔 (Round Rock, Texas)
34. drchrono (加州山景城.).
该公司的收入周期解决方案包括Apollo和Apollo+. Apollo允许drchrono 电子健康档案用户从电子健康档案管理帐单, 而Apollo+则为用户提供该公司完全托管的计费服务.
35. Experian Health (Austin, Texas).
36. FTI Consulting (芝加哥)
37. G4 HealthSystems (Tulsa, Okla.)
38. GeBBS医疗解决方案 (加州玛丽娜德雷伊(Marina del Rey).)
Technology includes the enterprise-wide 编码 solution iCode, 编码 compliance platform iCode Assurance, 业务流程管理工具iP2P和EOB到ERA转换工具iERA.
39. GE Healthcare (英国小查尔方特)
40. Greenway Health (Carrolton, Ga.)
41. 哈雷咨询集团 (Westerville, Ohio)
哈雷咨询集团 offers consulting services exclusively to the healthcare industry. The group's revenue cycle division offers services including the creation of a revenue cycle management work group, 文档的改进, practice education, transitioning central billing to central processing, establishing accountability standards and more.
42. Harmony Healthcare (Tampa, Fla.)
该公司提供临时、临时到永久和永久的人员配备解决方案. Harmony has worked with a number of healthcare providers including Ascension Healthcare based in St. 路易斯,约翰霍普金斯大学总部设在巴尔的摩,耶鲁-纽黑文(康涅狄格州)医院等.
43. 海斯管理咨询 (Newton Center, Mass.)
该公司的收入周期咨询服务包括评估, 优化和过渡管理.
44. 医疗业务的见解 (Milwaukee)
45. 医疗资源组 (斯波坎谷,洗.)
46. 硫化汞 (Lisle, Ill.).
47. 人类的弧 (Cleveland)
48. 休伦咨询集团 (芝加哥)
49. 显示 (Las Vegas).
50. Impact Advisors (Naperville, Ill.).
Impact Advisors is a healthcare consulting firm offering expertise in a broad range of areas, 包括策略性资讯科技规划, 临床优化, meaningful use, 收益周期管理等等. The company's RCM optimization services include patient access, charge services, case management, health information management and 病人的金融服务. 在2015/2016年度最佳KLAS排名中, Impact Advisors was named the Best in KLAS Overall IT Services Firm and the top firm in the IT Advisory Services market segment.
51. Intermedix (佛罗里达州劳德代尔堡.)
52. Jacobus Consulting (Irvine, Calif.)
53. KeyBank (Cleveland)
该银行的kepatient POS系统旨在简化收集工作, reduce bad debt, decrease days in accounts receivable and more. KeyBank还提供支付管理解决方案设计,以跟踪财务业绩和全面改善收入周期管理流程.
54. 卡夫卫生保健咨询 (Nashville, Tenn.)
55. Leidos (Reston, Va.)
56. McKesson (San Francisco).
57. MedAssets (Alpharetta, Ga.).
58. MedAssist医疗解决方案 (Louisville, Ky.)
MedAssist的收入周期解决方案包括几种患者访问技术, 比如一个有耐心的账单估算员, 还有几项商务办公服务, 比如拒绝管理和跟踪.
59. MedeAnalytics (Emeryville, Calif.)
60. MedHelp (Baltimore)
该公司专门处理紧急部门的MCO拒绝上诉. Additionally, the company developed an internal scrubbing program that allows for expanded medical 编码 review and scrubbing.
61. MediRevv (Coralville, Iowa).
MediRevv specializes in helping hospitals, health systems, academic medical centers and physician groups improve their cash flow and grow their revenue. Gpk电子提供自付和保险的扩展业务办公服务, 编码 and denials management services and more. 该公司的客户包括位于弗吉尼亚州里士满的Bon Secours健康系统公司., and Dignity Health, based in San Francisco.
62. 我公司 (Westwood, Mass.).
63. MedSynergies(欧文,德克萨斯州).
64. 子午线医疗管理 (Windsor, Conn.).
子午线医疗管理 services more than 40,000 healthcare providers each year and processes more than $5 billion in revenue for medical practices. The company was acquired by GE Healthcare in 2005, but re-established as a private entity. 该公司在许多不同的平台上提供医疗账单服务, such as Allscripts, eClinicalWorks, GE Centricity, NextGen EPM和VertexDr. Additionally, 子午线医疗管理 will operate on the Epic platform for its academic medical center clients.
65. MiraMed全球服务 (Lombard, Ill.).
The company offers hospitals and physicians patient services, billing services and reimbursement solutions, as well as practice management and consulting options.
66. 国家医疗计费服务 (Grover, Mo.).
67. Navicure (Duluth, Ga.).
Navicure's portfolio includes cloud-based healthcare claims management and patient payment solutions. 该公司有几个为特定RCM功能量身定制的产品线. Naviure ClaimFlow包括资格验证的解决方案, 编码, claims management, 汇款管理 and denials and appeals management. 该公司所有的解决方案都由其3-Ring客户服务支持, which guarantees a service representative will answer each client call in three rings or less.
68. Navigant Cymetrix (Irvine, Calif.).
69. NaviNet (波士顿).
NaviNet拥有40多个健康计划合作伙伴和42万名活跃用户. NaviNet的收入周期资源主要用于确定患者的自付费用. 该组织的支付估算器(Payment Estimator)允许提供商验证其资格,并准确估计患者的经济责任.
70. Nearterm (休斯顿).
The company's core RCM offering is Nearterm 360°. The solution incorporates health information management, consulting, permanent executive search and temporary staffing.
71. NextGen Healthcare (Horsham, Penn.).
The company's revenue cycle division offers consulting and outsourcing for physician billing, 集合和索赔. NextGen Healthcare's revenue cycle management services are driven by technology and proprietary solutions.
72. 北欧 (Madison, Wis.).
73. NueMD (Marietta, Ga.).
NuedMD的医疗账单软件和电子健康档案一起工作,以减少未偿索赔, 提供定制的转发和更多. The company's practice management services aim to reduce patient cancellations and boost claims acceptance.
74. Ontario Systems (Muncie, Ind.).
75. 360年为联合健康集团 (Eden Prairie, Minn.)
76. Parallon (Franklin, Tenn.)
The company, which employs 14,500 plus people, is partnered with more than 700 facilities and 6,000年医师实践. Parallon offers full-service revenue cycle outsourcing, consulting, payment compliance, collections, physician billing, 扩展商务办公室服务 and more.
77. Patientco (亚特兰大).
78. 医生组管理 (Lyndhurst, N.J.).
PGM, founded in 1981, offers physician billing services, facility billing services and EMR solutions. The company offers billing solutions specifically tailored to a number of different specialties including allergy and immunology, anesthesiology, 心脏病学, chiropractic, dermatology, emergency medicine, gastroenterology, mental health, 肾脏学, 肿瘤学, orthopedics, pain management, 初级护理和泌尿科.
79. PNC Healthcare (芝加哥).
80. nThrive (Wayne, Pa.).
81. 棱镜医疗合作伙伴 (芝加哥)
The company's revenue cycle solutions hone in on identifying any inefficiencies and boosting net revenues. Prism的解决方案包括注册, 保险验证, 金融咨询, charge capture, 编码, collections, 管理式医疗合同, 临床记录等.
82. 普华永道 (New York)
Its core offering is its Virtual Business Office, 作为客户医师业务办公室的延伸. VBO提供第三方应收账款老化修复, 保险验证, 声称卷管理, 客户服务支持等等.
83. Quadax (米高度,俄亥俄州)
84. Quorum卫生资源 (Brentwood, Tenn.).
85. Recondo Technology (格林伍德村,科罗拉多州.).
86. 摄政收入周期管理 (Westchester, Ill.)
The company offers billers and collectors with an average of more than 17 years of revenue cycle management each. 该公司提供一系列自动化服务,包括保险核查, 电子索赔处理, electronic payer payments and patient remittance posting, 数字化存储合同, outsourced patient statement generation and report formatting.
87. RelayHealth (Emeryville, Calif.).
RelayHealth, owned by McKesson, offers 分析-driven revenue cycle management solutions. The company's products include RelayAnalytics Acuity, RelayAnalytics Pulse and RelayAnalytics Spectrum. The Acuity product focuses on providing data to support decisions in areas ranging from ICD-10 compliance to reimbursement. The Pulse product helps create meaningful benchmarks. Spectrum产品是一款iPad应用程序,旨在允许移动设备访问数据.
88. RSM US LLP (芝加哥)
89. re|solution (Louisville, Colo.)
90. RevClaims (Jackson, Miss.).
91. RevenueXL (Cupterino, Calif.).
92. RevSpring (Wixom, Mich.).
93. Rycan (Minneapolis).
94. SCI Solutions (Campbell, Calif.).
95. SourceMed (Birmingham, AL).
SourceMed认证编码员团队, 收费员和收费员确保索赔持续进行,以便客户更快地实现盈利,并符合不断变化的法规. Actionable data, pulled directly from SourceMed billing software, highlights revenue cycle trends and identifies immediate opportunities to strengthen financial and operational outcomes.
96. 专业计费解决方案 (Lakewood, Colorado)
该公司的团队包括认证的专业编码器,经验丰富的账单 & 收集专业人员和百分之百在美国. The company performs “forensic collections” on new client accounts with existing A/R to capture proper reimbursement for old claims. ASCs making the switch to 专业计费解决方案 have realized increases in net revenue per case of at least 10 percent.
97. The SSI Group (Mobile, Ala.)
98. 对称的收入解决方案 (Fort Meyers, Fla.)
99. 道明银行 (Toronto, Ontario)
100. 白石集团 (Knoxville, Tenn.)
101. TransUnion (芝加哥).
102. Transworld Systems (Santa Rosa, Calif.).
103. 川本尼奇 (Mobile, Ala.).
104. 统一收集局 (Toledo, Ohio).
105. VisiQuate (Santa Rosa, Calif.).
VisQuate offers a number of products including an enterprise performance management platform, 可视化操作系统, 业务分析引擎, 知识分布引擎, business rules management and data integration studio. In 2014, VisiQuate partnered with Ovation Revenue Cycle Services to offer its healthcare clients a combination of revenue cycle software and services.
106. VitalWare (Yakima, Wash.).
107. VHC (lisle的露台,病了.).
108. Xtend Healthcare (亨德森,田纳西州.).
109. ZirMed (Louisville, Ky.).
110. Zotec Partners (Carmel, Ind.).
111. Access Healthcare
Access helps organizations drive sustainable excellence by using a three-step operating model that involves creating a best practice process, 应用正确的技术,招聘和留住正确的人才. Access has experience in all hospital and physician billing platforms and is legally compliant in all 50 U.S. 州.
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