TELCOR RCM minimizes billing staff and improves revenue cycle accuracy and compliance through automated workflow. All inbound and outbound data is controlled through interfaces requiring no manual intervention. Whether it is receiving patient demographic and charge data, or sending and receiving payer data, it is all automatic and audited. This processing reduces labor on the front end and produces compliant claims the first time so less time is spent working claim denials.
An exception-based rules engine is integrated 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. To manage records that fail a rule, paperless workqueues are used for user efficiency.
Rules can be created 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
Pre-processing rules ensure charge transactions are coded, grouped, exploded, imploded, validated and priced based upon each payer and client requirement. Missing patient information is automatically faxed, emailed or presented in the client portal allowing information to be obtained efficiently. Payer jurisdictional rules ensure claims are directed to the right payer the first time and automated benefits eligibility, prior authorization, diagnosis and CPT coverage checks prior to claim submission reduce denials.
All revenue cycle reporting such as customized KPIs, AR reports, productivity metrics, profitability and financial reporting can be scheduled for automatic distribution to your email as a PDF, Excel® or CSV file, and at whatever frequency meets your management needs.