RCM Services

PATIENT SCHEDULING AND APPOINTMENT MANAGEMENT

CPJ Techno Solutions provide the Tailor made Complete Revenue Cycle Management (RCM) solutions for the Clients based on their requirement in the US HealthCare verticle.

RCM processes like Patient information (Personal and Insurance info), Credentialing with insurances, Provider Charges (Symptoms and Treatment), Coding review, Claims Submission (Electronic and Paper), Sending out Patient Statements, Payment postings, Denial Management and finally work towards resolution on outstanding insurance and patient claims, are the services catered to our valuable Clients.Accurate coding by certified coders and timely follow-up with the insurance and patients will bring more collections to the provider, consistently.

Categories

PATIENT SCHEDULING AND APPOINTMENT MANAGEMENT:

PATIENT SCHEDULING AND APPOINTMENT MANAGEMENT:

  • Scheduling of patient’s appointment through the provider’s online portal thereby streamlining the pre-registration process .
  • Collection of patient’s demographics for eligibility and prior authorization requirements .
  • Fixing the schedule based on the provider’s availability .
  • Directly communicating with physician and patients through the messaging system .
  • Informing the patient about the appointment and seeking for confirmation .
  • Sending automated reminders to the patient and provider .

APPOINTMENT MANAGEMENT:

APPOINTMENT MANAGEMENT:

  • Reduces patient no-shows
  • Improves patient engagement
  • Organizes physician calendar for optimized appointment management
  • Provider real-time dashboard to physicians showing appointments
  • Automated reminders and follow-ups
  • Allows end-to-end tracking of patient payment history and outstanding payments.

ELIGIBILITY VERIFICATION & PRIOR AUTHORIZATION :

ELIGIBILITY VERIFICATION & PRIOR AUTHORIZATION :

  • We receive our workflow through the patient scheduling system, EDI, Fax, emails, and FTP files.
  • We then verify primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible and co-insurance information, and benefit information.
  • We use the best channel (call or web) to connect with the payer.
  • We contact the patient, in case of missing or invalid information.
  • We assess automated eligibility verification using our RPA tools.

PRIOR AUTHORIZATION :

  • Determine prior authorization requirements.
  • Prepare and submit paperwork to the payer.
  • Follow-up on submitted prior-authorization requests.
  • Notify the client for any issue with the authorization request.
  • We assess automated eligibility verification using our RPA tools.

CPJ’S VALUE PROPOSITION FOR ELIGIBILITY VERIFICATION SERVICES :

  • Optimize cash flow.
  • Reduce patient related denials.
  • Avoid rejection of claims by payers due to inaccurate or incomplete information .
  • Identify the patient’s responsibility upfront.
  • Improve patient satisfaction.