Revenue Cycle Management Clinic Software (RCM) unifies the administrative and clinical functionalities of a Clinic by coupling Patient data, such as Personnel Details, insurance provider with the treatment he receives and his healthcare data. It tracks Patient Treatment episodes from registration and appointment scheduling to the final settlement of his bill. It involves checking patient insurance eligibility, coding claims, handles Insurance claims, process payment and thus helps Clinics to maximize their revenue.

During Pre-registration the Reception staff creates a patient account which includes medical histories and insurance coverage. This is to ensure that insurance companies will reimburse the Clinic for medical services provided and that provides the groundwork by which claims can be billed and collected in the most efficient and effective manner within the shortest possible time possible.

After the patient receives treatment for a given condition and supplies; a Medical Coder/Clinic staff categorizes the nature of the Treatment according to ICD-10 and CPT codes. The Clinic / Hospital then sends the Treatment Summary with ICD and CPT (Current Procedural Technology) codes to the patient’s insurance company to see what portion of the treatment will be covered by insurance, while the patient is billed for the remainder which is in other words termed as ‘Copay’.

The Receptionist, Clinic assistant, Nurse, Doctor and the Accountant enter all the documents pertaining to the Claim and thus the service is billed and e-Claim is submitted to the Insurance Companies for processing.

After a claim is created, it is sent to the private or government Insurance payer for reimbursement. Meanwhile the Revenue Cycle Management Clinic Software automates the back-end office tasks associated with claims, reimbursements like payment posting, statement processing, collections, and handling of claims denials.

Once an insurance company evaluates the claim, Clinics are usually reimbursed for their services depending on the patient’s coverage and payer contracts. In some cases, claims can be denied for various reasons, such as improper coding, missing items in the patient chart, or incomplete patient accounts. By using PappyJoe’s efficient RCM these denials can be minimized and thus the Clinic Revenue can be Maximized.

For anything that is not covered by insurance, the Clinic notify and collect payments/copay from the patient directly and the PappyJoe’s RCM Software clearly guides the Clinic for the same and thus the Clinic Revenue is Maximized.

Need to Know More..? Call Us Now +91-9496499891