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Revenue Cycle Management

RevRCM is an Integrated end-to-end solution to manage all aspects of Revenue Cycle Management

  • Supports multi-specialty capabilities
  • Leverages proprietary technology & analytics led framework
  • Offers KPI driven performance management

Our Approach

Our RCM framework is built upon three key assets at the core of our end-to-end revenue cycle capabilities: Industry Best Talent, Proven/Time Tested Methodology and Forward Looking Dynamic Technology. Reventics’ strategy is to enable the practice’s success based on KPI Driven performance management and utilizing technology & automation capabilities to create an optimized solution.

Capabilities

Multi-Specialty Capabilities

Our multi-specialty RCM capabilities span across both surgical and non-surgical specialties. Leveraging our CDQI and CAS solutions, we provide a clinically driven RCM model that creates a unique solution set for our clients, irrespective of the specialties they operate in. Given below is a list of some of the specialties for which we provide RCM solutions for our clients:

  • Anesthesia
  • Emergency Department
  • Hospitalists
  • Internal Medicine
  • Neurology
  • Ob-Gyn
  • Orthopedics
  • Pathology
  • Pediatrics
  • Pulmonology
  • Radiology
  • Surgery
  • Telehealth
  • Urgent Care
  • Urology

TECHNOLOGY & ANALYTICS LED SOLUTIONS

Business Intelligence and proprietary tools help streamline operations and facilitate yield management workflows that enhance cash collections year over year. Reventics utilizes innovation and automation to create rules based engines that drive action, route documents, reduce manual touches, and maximize revenue capture. Some examples of our approach are as below:

  • Deploy automated claims status and other technology based solutions
  • Implement rule based work allocation algorithm
  • Utilize analytics led insightful reporting package

KPI Driven Performance Management

Our analytics based operational model optimizes people, process and technology to transform our client’s businesses. Significant emphasis is given to denial prevention, eligibility verification and search, medical necessity checks, documentation improvement and aggressive inventory management to reduce leakage and reduce bad debt expense. Our engagements are KPI (Key Performance Indicators) driven and focus on the following:

  • Identify Current baseline
  • Create practice specific KPIs and benchmarks
  • Implement quarterly KPI targets

Solutions Overview

Patient Access
Reventics provides end-to-end Patient Access services, including Appointment Scheduling, Eligibility Verification, Pre-Authorization and Financial Counseling. Reventics’ analytics focus on and help identify the most productive opportunities to collect co-pays, co-insurance, deductibles and self-pay amounts during each stage of the revenue cycle.

Billing and Claims Management
During the assessment phase, Reventics benchmarks the clean claim and first pass rates and compare against industry Best Practices. An audit of claims failing to pass the bill editor software will be conducted. Based on the result, Reventics identifies Root Causes and works with the appropriate teams (e.g. Patient Access, Coding or IT) to implement the required changes and bring the metrics within an acceptable range. Reventics’ services are focused on ensuring that claims contain complete, accurate data that results in timely, optimal payment. By applying a series of interrelated steps, including patient demographic validation, insurance mapping, and insurer-specific edits applied to diagnosis and procedure codes, we optimize our clients’ cash flows.

Payment Posting and Rejection Processing:
Reventics payment posting includes manual and electronic remittance payment posting and reconciliation services. It provides credit balance services to help ensure compliance with refunds of over payments. Cash Policies and Procedures are evaluated and improved as needed. As changes are implemented, we audit to identify procedural compliance. Reventics ensures that proper reconciliation processes exist to tie the cash records to actual deposits and provide the required reconciliation reports back to the Accounting and Finance departments.

Account Receivable Management
Reventics provides Account Receivable Management services for physicians that significantly improve the timing and amount of collections. Our team of highly qualified A/R professionals will apply tailored approaches to the accounts receivable based on age, insurance type and dollar threshold to accelerate collections. With our open technology platform for Accounts Receivable Management, Reventics seamlessly transitions clients’ accounts with no impact to cash flow.

Denial Management & Analytics
Reventics Denial Management services include: structured workflows to classify and work denials; appeals tailored to specific denials; analytics to trend denial patterns and appeals success; and feedback loops to correct upstream processes and edits to eliminate denials in the future. As remittance information is processed, we evaluate the denials and perform a root cause analysis to identify the source. We implement solid policies and procedures for the Denial Management team to track trend and communicate issues with a focus on the front and back end staff education as well as system adjustments as needed to assist in denial reduction and prevention.