• Home
  • Revenue Cycle Management

Revenue Cycle Management

Agisol partners with healthcare organizations to speed up the reimbursements, close the gaps for denials, stop revenue leakages, by reducing costs and improve patients experience with disruptive automation technologies.

 

Provider Enrollment and credentialing  

Agisol works with Providers for their enrollment and credentials which involves steps like completing application forms, providing clarifications to queries from payers to close the credentialing request.

 

Patient scheduling and appointment

Agisol helps the Patients in Scheduling an appointment without long hold times, in-turn helping the providers a smooth appointment management, by directly communicating with providers and patients through messaging system, calling the patients, informing about the appointment and seeking confirmation and also sending automated reminders to the patient and provider

 

Patient Pre registration:

Agisol helps the Medical Practice to capture important demographics, insurance information, eligibility through a clearing house, helping the Provider’s practice management system to know about the patient’s coverage, deductible, co- insurance, co-payment and also about the referrals.

Since preregistration is the first step and determines the financials for the provider, it is the key process to get the exact details for a strong start to the revenue cycle process.

 

Patient Registration

After preregistration the registration process becomes easier to get 100% of patient information.  With registration, the provider makes sure the patient’s Demographics, guarantors, and insurance information are accurate and becomes a record for future references.

At this stage co- payments are collected and referrals, authorization for treatments are done. All financial forms signed and insurance benefits will be assigned. All the above are thoroughly done by Agisol expert team. So that the entire documents are ready in case of audit, helping practices easily avoid all financial risks.

 

Charge Capture

Agisol expert team Captures Charge in two methods both manually or through automated process which include even ancillary services and coding services.

 

Coding Services

Agisol Coding team enables the Providers to arrest revenue leakage by reducing the discharges not fully billed with coding accuracy. With the findings form our internal audit team, we drive clinical documentation initiatives and help the coding team to work with Providers to reduce denials.

 

Claim Submission

After the Charge Capture, Agisol team works on Claim submission which includes sending the captured data to the insurance carrier. The revenue cycle team works on the charges if any, and checks for the CPT codes, and the diagnosis codes.

Claim are scrubbed free of errors and ensured to get into the insurance carrier process clean for a faster payment. Here Agisol team sends claims form the Provider’s practice to the clearing house, acting as a mailer room and sending to different insurance payers.

Once the transmission reports generated, the rejection report is reviewed and fixed immediately for the claims to get paid ASAP.

 

Remittance Processing

Explanation Of Benefits in the remittances help the Agisol team to know the details of the payments to the providers for the service provided. Allowables are determined in the process according to the provider’s contracted with insurance carriers on the services provided.

Agisol team verifies for the shortfalls in the remittances, which are usually neglected by provider’s team for the lack of time, to go through each and every EOB. Agisol team appeals for such errors to get back the part payments.

This process includes review of the fee schedules on annual basis to ensure that the fee is adjusted in rates, contracts and allowables, also write-offs, contractual write-offs cannot be prevented as they involve the actual contracted rates with Payers.

Agisol looks for the points that can be avoided in the remittance process which effect the RCM and helps the Providers to avoid unnecessary reprocessing.

 

Account Receivables Follow-up

Agisol A/R report regenerate the reports bucket wise for a period of time.

Agisol teams are capable and are cross trained for different Carriers and aging reports, different practice managements, Medicare, Medicaid, appeals.

 

Denial Management

Agisol team easily determine the causes of denials and quickly mitigate the risk of the future denials and tries to get the providers paid faster. Denial management is very critical to healthy cash flow.  Agisol team focuses mainly on the root cause and denial prevention.

 

Patient Collections

Agisol team sends out the monthly statements for Patient Collections to the patients to remind them of deductibles/ co payments