TSG Revenue Cycle Management

Revenue Cycle Management

Revenue-Cycle-Management-Workflow

Leverage Your Existing Technology

Regardless of which EHR/EMR you use in your facility, API integrates seamlessly with your workflow to provide customizable and easy-to-read benefit statements to view the patient estimated cost. Submit eligibility requests via API integration, file upload or direct data entry, and receive information directly from payers and also integrate returned data into your practice management system. The secure cloud-based/hosted API platform is integrated with the Microsoft Azure software.

Revenue Cycle Management (RCM) Portal
It’s important to verify each patient’s insurance eligibility before the hospital or provider office visit to confirm that the patient information is correct and up-to-date.

TSG’s automated verification service identifies issues related to the patient’s coverage and takes corrective action before the patient even arrives. Identifying patient responsibility upfront prior to the visit will considerably reduce rejected and delayed claims and the time required for patient check-in, as well as increase productivity.

Denial Management:

Denial management is a critical element for successful revenue cycle management.

  • Coding/registration-related errors.
  • Ineligible/non-covered service.
  • Incomplete/inaccurate demographic information.
  • Missing information/claims not filled in time/duplicate claim.

API/Services to Provide Eligibility
Even if the full information isn’t verified before the patient arrives, it can be quickly and accurately be verified at the point of care from within your application.

  • Reduce the overall wait time for the patients.
  • Minimize patient denials, avoid rejection of claims and delays in payment, boost revenue, save time on the back end, and also improve patient satisfaction.
  • Eligibility, plan summary, and claim status information is available in a real-time – 24 hours a day, seven days a week, 365 days a year.
  • Real-time views of employee work queues
  • A real-time online dashboard provides snapshots of workflow status that show projected workloads by user or role .

Benefits/Savings:

Batch Eligibility Verification

  • Submit eligibility request for multiple recipients at the same time.

Streamlines/Automate Workflow

  • Eligibility responses are consistently viewed, which improves overall efficiency of the process.
  • Automatically manages and routes claims in real time to user work queues based on configured routing rules based on prioritization and routing of work items based on specific data elements, user skills, lines of business and other variables.
  • Prioritize claims based on payer, dollar amount, time, age of bill, or other business rules to ensure maximum benefits.

Cost-Effective

  • Through a centralized approach using a API, you can save transaction fees by not repeating same eligibility transactions more than once unless it is expired.
  • Eligibility verification is only done when it is needed – you do not have to pay twice for the same eligibility verification.

Increase Productivity

  • Increase productivity through time-saving automation, batch processing and real-time eligibility and benefits verification.
  • Improve staff productivity – Reduces the time spent on complex manual processes.

Features

Auditing

  • Comprehensive audit trails and ensuring compliance.
  • Track your claims through the entire process and easily identify rejections and denials that need to be addressed.
  • Audits eligibility information for accuracy in your EHR/EMR

Analytical Reports – Usage & Trends

  • Monitor and analyze claim denials – helps you identify patterns and opportunities to prevent future claim denials.
  • Custom reporting capabilities*
  • Trend tracking helps to reveal billing, registration and medical coding process weaknesses

Validation

  • Error-free patient demographic entry results in increased clean claim transmission and timely reimbursement.
  • Avoid rejection of claims due to inaccurate or incomplete demographic information.

Integration

  • APIs allows for simple, easy integration into any application
  • Ability to provide eligibility through integration into any application including Meditech.
  • Access the most payer connections in the industry