Revenue Cycle Management

RCM SERVICES

We Deliver our Experience and Expertise to achieve your Excellence

Comprehensive and effective services designed to improve your cash flow

AnnexMed is a leading provider of Revenue Cycle Management Services empowering healthcare organizations to achieve business transformation and growth through our innovative healthcare information system and services. An experienced Medical billing and coding company knows that a strategic approach to insurance and patient billing generates greater results. This makes us a premier on/offshore billing company, supporting our clients to achieve cash flow success. We understand that every client is different. We don’t stand on ceremony around our company standards. We strive to help you achieve your objectives by doing whatever is necessary to get the job done and consistently work towards achieving operational excellence to earn more business.

Pre-Claim Services

Patient Access Services

Clinical Revenue Integrity

Patient Financials

Top 10 Challenges

Reimbursement Changes

Lack of Skilled Manpower

Increasing Operational Costs

Payer Contract Negotiation

Patient Satisfaction Scores

Regulatory Requirements

Declining Reimbursements

Prior Authorizations Denials

Poor Patient Reimbursements

Value-based Payment Models

Professional Services, Personal Attention and Proven Results

Pre-Claim Services

  • Contract Negotiations
  • Credentialing Services
  • Provider Enrollment
  • EDI Enrollment
  • EFT/ERA Enrollment
  • Consulting Services

Patient Access Services

  • Appointment Scheduling
  • Patient Registration
  • Eligibility & Benefits
  • Prior Authorization
  • Patient Follow-up
  • Patient Notification

Clinical Revenue Integrity

  • Professional Coding
  • Facility Coding
  • Coding Audit Services
  • Risk Adjustment Coding
  • Charge Capture Analysis
  • Clinical Documentation

Patient Financial Services

  • Charge Capture
  • Scrubbing and Submission
  • Payment Applications
  • AR Management
  • Denial Management
  • Insurance & Patient Follow-up

Unique, Rapid and Superior services for your practice

AnnexMed is committed to track every submission and work every claim through to resolution. Our team of revenue cycle experts, certified coders and call center executives are supported by latest technology that aids their workflow to increase reimbursement.

AnnexMed best practices ensure that compliance is integrated into our operations. We supplement these policies and procedures with internal and external audits. At AnnexMed we understand the difference between cutting costs and generating back-end revenue. That’s why we educate our professional staff in the latest cash recovery techniques and compliance standards—and support them with state-of-the-art technology.

Pre-Claim Services

Time is money when it comes to insurance enrollment and credentialing so partner with the experts!

Contract Negotiations

Compare the reimbursement rates offered by insurance agencies with the existing market rates and norms.

Periodically review the contracts at regular intervals, in line with the current situation.

Credentialing Services

Complete all necessary credentialing requirements for each payor and follow through to completion.

We give you a dedicated expert credentialing specialist that will work on your behalf.

Provider Enrollment

We complete all applications and necessary paperwork on your behalf with the chosen payor networks and government entities.

Maintain and update CAQH profile.

EDI Enrollment

Evaluate customers EDI service needs and facilitate the enrollment processes.

Perform EDI setups and interact with payers for enrollment related matters.

EFT/ERA Enrollment

Verifies enrollment requirements; payer association; verifies provider EFT/ERA setup.

We make all the phone calls, follow-ups, and submit all applications, e-mails and faxes for you.

Consulting Services

Analyzes every step of the revenue cycle process to help you identify potholes and put in place solutions to maximize revenues.

Questions on training or implementation of new billing systems.

Partnering with AnnexMed means you focus on your business while we focus on your business needs

Maintain & Update CAQH profile

Monthly or quarterly audits of credentialing files

Increased network participation & Membership

No payment delays due to incorrect contracts

Experienced enrollment analysts use best practices

Gives you more time to concentrate on your patients

Gives you the advantage of getting experts to do the job

Allows your staff to concentrate on billing and collections

Saves you tons of paperwork and hours of frustration

Patient Access Services

Before patient care, it’s important to start laying the foundation for a payable claim

Appointment Scheduling

Centralized appointment scheduling, extended hours of appointment scheduling.

Decreased no-show rates through automated appointment reminders.

Patient Registration

Registration of new patient with accurate and complete patient personal details, insurance details etc.

Updation and verification of old patients data.

Eligibility & Benefits

Complete information on deductibles, co-pays, out-of-pocket maximums and benefit limitations.

Verify coverage on all primary and secondary using WebMD, payer web sites and phone calls to payers.

Prior Authorization

Turnkey all-inclusive prior authorization services (Authorization Request + Follow-up + Approval).

We contact the insurance company and attempt to obtain pre-auth.

Patient Follow-Up

Handling patient calls with questions about their statements, calling patients for outstanding balance.

Follow-up calls with patients via dedicated 800 number.

Patient Notification

Sending out statements and generating automated call reminders to patients. 

Patient share estimation provided prior to service.

Before patient care, it's important to start laying the foundation for a payable claim

Increases staff efficiency

Reduce cancellations and wait times

Improves your ability to get paid on-site

Reduces back-end patient billing expenses

Enhance patient satisfaction & experience

Increases up-front patient collections

Reduces the risk of denied claims due to errors

Lays a solid foundation for more payable claims

Increase revenue and reduce bad debt through

Decreases A/R days and bad debt by collecting early

Clinical Revenue Integrity

Business of medicine can be paralyzed without complete and up-to-date coding and reimbursement system knowledge and accuracy..

Professional Coding

We can help you improve accuracy with ongoing, periodic or one-time coding assistance across all medical specialties.

Guaranteed accuracy and turnaround leading to accurate and appropriate reimbursement.

Facility Coding

Expertise across diverse chart types including inpatient, emergency departments, ambulatory care, radiology, and surgery centers.

Special expertise in complex, high-value coding such as interventional radiology and cardiac catheterization.

Coding Audit Services

Accuracy review of your current coding process, which will identify mistakes and help prevent future coding-related denials.

Coding auditing services, including coding compliance, provider documentation and reimbursement audits.

Risk Adjustment Coding

Retrospective coding for Medicare, Commercial/HIX and Medicaid using models: CMS-HCC, HHS-HCC, and State Specific Medicaid.

Assure the highest standards of coding quality, with quality checks occurring throughout the process.

Charge Capture Analysis

Identify opportunities for process improvement in order to maintain a current, comprehensive and compliant CDM.

Charge capture review to identify and correct breakdowns in the charge capture process.

Clinical Documentation Improvement

Review of clinical documentation to support diagnosis capture and to ensure the level of service rendered to all patients is appropriately recorded.

Maximize reimbursement by improving your documentation and protect you against the risk of RAC audit liability.

Partnering with AnnexMed means you focus on your business while we focus on your business needs

Credentialed, experienced coders

Expertise in Physician / Hospital Coding

Minimum 20-30% cost reduction

12-24 Hours rapid turnaround

96% or better coding accuracy

Optimize revenue, decrease denials

Strict enforcement of coding compliance

A Process tailored to each client’s needs

Elimination of staffing shortages and turnover

Ensure accurate, compliant coding

Patient Financials

Our patient financial services optimize process and technology to improve all aspects of revenue cycle performance..

Charge Capture

Higher level of accuracy and zero lost charges, reduce compliance risks and improve patient satisfaction thereby.

Reducing denials, increasing revenues and reducing the chance of an audit by CMS or the OIG.

Scrubbing & Submission

Reviewing each claim on a line-by-line basis to ensure its properly coded and contains the correct information.

Solution to reduce undercharges and denials, saves staff time and improves your cash flow.

Payment Applications

Accurate payment posting process helps analyze the revenue cycle better for improvement opportunities to maximize revenue.

Both manual and electronic payments will be processed within 12-24 hours of the receipt.

AR Management

Each claim is meticulously tracked reviewed and followed up by our experienced A/R staff until the payment is received.

Committed to helping you increase net revenue and reduce the AR cycle while providing a high level of satisfaction.

Denial Management

Best practices for reducing the denials and putting strategies to increase the percentage claims getting paid promptly the first time.

Effective appeals process for improperly denied
claims.

Insurance & Patient Follow-Up

Timely follow up on all unpaid claims, ensuring that no time is lost on pursuing every reimbursement possibility.

Regular follow up with patients to pursue any outstanding balance.

How cash flow disruption can happen during the revenue cycle of healthcare oraganizations

24/7 Service and Support

12-24 Hours Rapid Turnaround

Credentialed Billers & Coders

Dedicated RCM Manager and Team

Extensive Insurance & Patient Follow Up

Stringent Quality Control Process

Sending Regular Patient Statements

Daily/Monthly/YTD Financial Reports

Appeal of Low Paid and Denied Claims

Secondary and Tertiary Claims Submissions

Service Highlights

AnnexMed’s ability to drive accurate reimbursements and avoid costly errors is a result of our team of highly experienced and rigorously trained medical coders & billers.

  • 24/7 Service and Support
  • 12-24 Hours Rapid Turnaround
  • Credentialed Billers & Coders
  • Dedicated RCM Manager and Team
  • Extensive Insurance & Patient Follow Up
  • Appeal of Low Paid and Denied Claims
  • Secondary and Tertiary Claims Submissions
  • Stringent Quality Control Process
  • Daily/Monthly/YTD Financial Reports
  • Sending Regular Patient Statements

Pre-Claim Services

Time is money when it comes to insurance enrollment and credentialing so partner with the experts!

 

Contract Negotiations

Compare the reimbursement rates offered by insurance agencies with the existing market rates and norms.

Periodically review the contracts at regular intervals, in line with the current situation.

 

Credentialing Services

Complete all necessary credentialing requirements for each payor and follow through to completion.

We give you a dedicated expert credentialing specialist that will work on your behalf.

 

Provider Enrollment

We complete all applications and necessary paperwork on your behalf with the chosen payor networks and government entities.

Maintain and update CAQH profile.

EDI Enrollment

Evaluate customers EDI service needs and facilitate the enrollment processes.

Perform EDI setups and interact with payers for enrollment related matters.

 

EFT/ERA Enrollment

Verifies enrollment requirements; payer association; verifies provider EFT/ERA setup.

We make all the phone calls, follow-ups, and submit all applications, e-mails and faxes for you.

 

Consulting Services

Analyzes every step of the revenue cycle process to help you identify potholes and put in place solutions to maximize revenues.

Questions on training or implementation of new billing systems.

×

Patient Access Services

Before patient care, it’s important to start laying the foundation for a payable claim

 

Appointment Scheduling

Centralized appointment scheduling, extended hours of appointment scheduling.

Decreased no-show rates through automated appointment reminders.

 

Patient Registration

Registration of new patient with accurate and complete patient personal details, insurance details etc.

Updation and verification of old patients data.

 

Eligibility & Benefits

Complete information on deductibles, co-pays, out-of-pocket maximums and benefit limitations.

Verify coverage on all primary and secondary using WebMD, payer web sites and phone calls to payers.

Prior Authorization

Turnkey all-inclusive prior authorization services (Authorization Request + Follow-up + Approval).

We contact the insurance company and attempt to obtain pre-auth.

 

Patient Follow-Up

Handling patient calls with questions about their statements, calling patients for outstanding balance.

Follow-up calls with patients via dedicated 800 number.

 

Patient Notification

Sending out statements and generating automated call reminders to patients. 

Patient share estimation provided prior to service.

×

Clinical Revenue Integrity

Business of medicine can be paralyzed without complete and up-to-date coding and reimbursement
system knowledge and accuracy..

 

Professional Coding

We can help you improve accuracy with ongoing, periodic or one-time coding assistance across all medical specialties.

Guaranteed accuracy and turnaround leading to accurate and appropriate reimbursement.

 

Facility Coding

Expertise across diverse chart types including inpatient, emergency departments, ambulatory care, radiology, and surgery centers.

Special expertise in complex, high-value coding such as interventional radiology and cardiac catheterization.

 

Coding Audit Services

Accuracy review of your current coding process, which will identify mistakes and help prevent future coding-related denials.

Coding auditing services, including coding compliance, provider documentation and reimbursement audits.

Risk Adjustment Coding

Retrospective coding for Medicare, Commercial/HIX and Medicaid using models: CMS-HCC, HHS-HCC, and State Specific Medicaid.

Assure the highest standards of coding quality, with quality checks occurring throughout the process.

 

Charge Capture Analysis

Identify opportunities for process improvement in order to maintain a current, comprehensive and compliant CDM.

Charge capture review to identify and correct breakdowns in the charge capture process.

 

Clinical Documentation Improvement

Review of clinical documentation to support diagnosis capture and to ensure the level of service rendered to all patients is appropriately recorded.

Maximize reimbursement by improving your documentation and protect you against the risk of RAC audit liability.

×

Patient Financials

Our patient financial services optimize process and technology to improve all aspects of revenue cycle performance..

 

Charge Capture

Higher level of accuracy and zero lost charges, reduce compliance risks and improve patient satisfaction thereby.

Reducing denials, increasing revenues and reducing the chance of an audit by CMS or the OIG.

 

Scrubbing & Submission

Reviewing each claim on a line-by-line basis to ensure its properly coded and contains the correct information.

Solution to reduce undercharges and denials, saves staff time and improves your cash flow.

 

Payment Applications

Accurate payment posting process helps analyze the revenue cycle better for improvement opportunities to maximize revenue.

Both manual and electronic payments will be processed within 12-24 hours of the receipt.

AR Management

Each claim is meticulously tracked reviewed and followed up by our experienced A/R staff until the payment is received.

Committed to helping you increase net revenue and reduce the AR cycle while providing a high level of satisfaction.

 

Denial Management

Best practices for reducing the denials and putting strategies to increase the percentage claims getting paid promptly the first time.

Effective appeals process for improperly denied
claims.

 

Insurance & Patient Follow-Up

Timely follow up on all unpaid claims, ensuring that no time is lost on pursuing every reimbursement possibility.

Regular follow up with patients to pursue any outstanding balance.

×