The TELCOR RCM rules engine utilizes exception-based processing which is integrated throughout the software and surrounds all revenue cycle processes required to bill and manage AR. Many rules are standard and even more are customizable to adapt to each laboratory’s unique requirements.
In order to manage any records that fail a rule, we offer paperless workqueues for user efficiency. Instead of reviewing everything, workqueues highlight only items needing user attention.
Rules can be defined to:
- Ensure accuracy of patient data
- Ensure billing transactions are complete and correct prior to billing
- Ensure payer claims and client invoices contain information as required by the recipient
- Ensure remittances process automatically
- Provide notification you are getting paid according to contract
- Assist with efficiently managing any bad debt and much more
This processing reduces labor on the front end and produces compliant claims the first time so less time is spent working claim denials.