Accounts Receivable Management

Maintaining cash collection levels during a system conversion is a difficult task, but paramount to your organization. We are committed to resolve A/R from the legacy system, boost cash collection levels, and improve financial performance, while your staff concentrates on a successful system implementation.

• Limits disruption to staff, users, and patients
• Allows revenue cycle leadership and key personnel to focus on successful implementation of the new system
• Produces meaningful reports per project goals with our proprietary database
• Assists our clients with identifying additional items of consideration including: peer-to-peer contacts, and decision-making

Denials from insurers result in lost revenue for your healthcare organization.  An effective claims denials management program increases revenue and collections rates, enhances the patient experience, and decreases future denials. Our specialized teams are highly proficient in working with, negotiating and navigating the complexities of the insurance system.

• Recovers denied services and enhances your bottom line performance
• Identifies payer denial trends and prevents future denials from happening
• Increases your cash flow with streamlined workflow and payer expertise

EMCsoft’s Claims Agent software delivers clean medical claims to payers for proper claim adjudication. Find and correct claim errors with our powerful and customizable rules engine. Claims are subjected to extensive edits that are personalized to the provider and payer. Multiple control points ensure that only clean claims are submitted.

• Maximizes payment by sending clean medical claims to payers
• Provides customer service to assist with your need including: bridge routines, edits, specialized reports, and destination routes
• Edits and submits Institutional and Professional claims to A/R system, payers, and clearinghouses; retrieve payer reports; rework rejected claims

Credit balances can lead to a lack of compliance, misunderstanding of the provider’s financial situation, and a reduction in staff productivity. PATHS identifies and refunds credit balances in a timely manner to ensure account balance is zeroed out. This resolves distortions in the revenue cycle including profitability and accounts receivable days. 

• Provide essential reporting that many receivable systems cannot
• Compliant with payers regulations
• Free up staff to concentrate on other accounts
• Keep current with noncash producing aspect of the revenue cycle

Credentialing and provider enrollment issues can cause delayed or denied reimbursement for services provided. Our goal is to ensure compliance and every collectible dollar is received. We utilize robust workflows to monitor contracts and submit applications. Our payers and regulations expertise result in a positive impact on your revenue.

• Affordable Care Act Medicare and Medicaid Revalidation
• Knowledge of all governmental and commercial payers
• Timeliness of application and document submission
• CAQH database building with facilities, practices and physicians
• E Contract and application process experience