RevMAX-led Revenue Cycle Management (RCM) Solution

Fully Integrate and Automate Your Healthcare Revenue Cycle Management

The right technology can improve collaboration between your providers and your revenue cycle staff thereby facilitating the flow of revenue across the business. RevMAX™ increases coordination and the level of communication between coding/HIM and providers and streamlines the relationship between providers and the revenue cycle. The result is fewer denials, better accounts receivable, and optimized revenues.

Value Delivered
Key Features
Closing the Gap

RevMAX – RCM program uses Machine Learning (ML) algorithms to predict and prevent denials, ensuring increased collections and decreased AR days

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Value Delivered to Healthcare Establishment

This ED focused, independent physician group deployed RevMAX – RCM Solution to:

Reduce front-end denials
Enable self-service business intelligence insights
Leverage machine learning insights to re-engineer processes across the revenue cycle

This resulted in:

6.2% increase in collections

10% improvement in days in AR

I can’t believe we achieved double digit improvement in RVUs and reimbursement.

— VP and Department Administrator

Large Community Health System with 7 Hospitals in the Mid Atlantic

RevMAX Key Features

RevMAX

Approach

Full continuum RCM and denials management excellence.

RevMAX

Self-Service Portal with Actionable Insights

Business intelligence, denial predications, and workflow all-in-one place.

RevMAX

ML Based Denials Predictions with Reason Codes

Summary of top impactors along with detailed encounter-level feedback that can be acted upon even prior to claims submission.

Closing the Gap

RevMAX is a fully integrated, automated, predictive analytics-based revenue cycle management (RCM) solution that maximizes revenue capture and reduces manual touches.

RevMAX takes practice management system (PMS) and electronic health record (EHR) data, applies machine learning technology and predictive algorithms to improve outcomes across:

Patient eligibility, pre-authorization, and collections
Denials prevention and denials management
Account receivable management

RevMAX delivers solutions spanning both the front end and the back end revenue cycle. Using rules-based and Machine Learning (ML) based engine, RevMAX is able to drive action, route documents, reduce manual touches, and maximize revenue capture. Emphasis is made on denial prevention, eligibility verification and search, medical necessity checks, documentation improvement and aggressive inventory management to reduce leakage and reduce bad debt expense.

RevMAX is unique because of the Machine Learning (ML) driven denials prevention capabilities.

As an RCM company, we believe in not only managing AR and denials at the back end but also a on the front end to prevent denials and increase time of service collections.

The self-service BI tool that is part of our RevMAX platform enables our clients to “slice and dice” the data in insightful, meaningful ways that are far superior to traditional standardized reporting provided by most Revenue Cycle Management (RCM) companies.

RevMAX goes beyond other RCM solutions because it:

Identifies potential denials upfront even before claim submission
Prioritizes and streamlines the work queue for claims resubmission
Informs upstream process changes to prevent future denials

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