REVENUE CYCLE MANAGEMENT
Lower Costs, Boost Revenue, and Drive Growth
Achieve a profitable revenue cycle through expertly aligned people, processes, and technologies
END-TO-END REVENUE CYCLE OUTSOURCING
Built on our comprehensive ProsperityEHR technology platform, our owned - not outsourced - US-based billing experts partner with you to configure the software and develop standard operating procedures to deliver improved financial outcomes
Before a Patient Visits
Our expert billing team partners with your front office and administrative staff to establish and refine processes that will:
- Increase cash on hand
- Reduce insurance denials
- Improve customer service
Patient Verification
Verify patient demographics and insurance
Coverage Check
Automate patient insurance coverage/eligibility verification
Patient Estimates
Generate patient estimates, include copay calculation and deductibles owed
Payment Setup
Collect copays, store credit cards on file, and set patients up on payment plans
After a Patient Visits
From the moment a charge is created, our billing team takes:
- Ownership of billing processes from charge creation
- Fast and efficient claim handling
- Focused on maximizing reimbursement
OUR REVENUE CYCLE SOLUTION
Discover Why Our Solution Drives Better Financial Outcomes
Delivering Improved Outcomes
- Recover missed revenue with improved charge capture, achieving an average 97%+ overall collection rate.
- Accurate insurance verification and integrated tools ensure 99.5%+ clean claim rates, speeding up payments.
- Boost collections with strategies like increasing self-pay collections from 7% to 76%, adding $40K in a single month.
Delivering Consistently
- Partner with a seasoned, expert billing team and client service specialists who understand your business and provide personalized, reliable support.
- Track progress with KPIs, tailored reports, and comparisons to similar organizations to drive measurable success.
- Regular check-ins and feedback meetings ensure continuous improvement, transparency, and a clear focus on your financial health.
Benefits of Revenue Cycle Management
Diagnosis Checks
Valid billing diagnosis checks
Encounter Checks
Missing encounter checks
Charge Review
Charge review and claim submission
Claim Submission
Clearinghouse submission and resolution
Paper Statements
Patient paper statement generation
ERA posting
Electronic Remittance Advices posting
Denial Follow-Up
Claim denial follow-up and resolution
Pre-Collections
Pre-collections processing
Payroll Reports
Payroll Reports
KPI Reports
Regular KPI checks and report-outs with customer leadership
Balance Alerts
Automate patient balance notifications via SMS/email, including detailed charges summary, secure credit card payment, and auto-posting of payments
REVENUE CYCLE MANAGEMENT FAQs
A successful transition of revenue cycle ownership doesn’t happen by accident - it’s a carefully planned and deliberate series of events. The ProsperityEHR revenue cycle leadership team will meet with your team to perform a comprehensive diagnostic evaluation of your current practices, both to learn how you operate and document standard operating procedures, as well as identify opportunities for improvement. We’ll then discuss and establish the roles and responsibilities of both teams, and propose / finalize standard operating procedures. We’ll also schedule regular leadership check-ins and establish the KPIs that will be reviewed. Once our team has engaged in the day-to-day work with your team, we will carefully monitor performance for the first 90 days to ensure that standard operating procedures are working as expected, and adjust iteratively if necessary.
Not only do claim denials mean you don’t get paid as quickly as you typically would - you have to spend more time (money!) to get paid for something you’re already owed, which cuts into your margin. The first, best cure for denials is prevention. Our RCM team understands the most important factors in preventing denials, and will establish the tools and processes to minimize them. For harder-to-avoid denials, our RCM team has a deep understanding of denial codes, the payer who denied the claim, the software knowledge to efficiently address and correct the issue, and persistence.
In our experience we have found that in most situations, our customers prefer to maintain the relationship with the patient and handle their inbound calls and questions, with the ProsperityEHR RCM team playing a supporting role. The ProsperityEHR RCM team will work with your staff to optimize and establish standard operating procedures to ensure a high-quality patient experience.