ProcessMed > Consumer Products > RCM Case Study – Hospitals 1

RCM Case Study - Hospitals 1

Processmed offers quality tools, methodology, and experienced and trained professionals to efficiently collect the outstanding A/R, help ensure claim data accuracy throughout the revenue cycle, and simply help to ensure proper reimbursement for services.  Each solution is custom-fit to the hospital’s culture and processes.  Processmed revenue cycle improvement solutions span the entire spectrum of the revenue cycle

  • Tertiary care Hospitals in Northern  Emirates
  • Mixture of E-Claims and paper Claims
  • Full  RCM Solution requirement  for the hospitals
  • Need to Improve Overall Performance  of the Hospitals on Insurance Receivables
  • Higher rejection rate
  • Low first pass Submission  payment rate
  • High percentage of Outstanding  AR > 90 days & 180 Days
  • Needed a Company to Deploy Solution to ensure the above metrics are improved resulting in better cash flows
  • Implemented  Multi layered Audit approach   and RCM Solution to take care of Clean Submission .
  • Created   Physician  Specific  Rejection   reporting   as well as key Performance Indicators to measure performance  and train the physician based of trends
  • Revamped the frontend authorization and eligibility verification process  to address frontend denials
  • Deployed Medical and coding Team to take care of Medical Necessity Issues
  • Conducted In depth Denial Analysis  to Identify  revenue related gaps.
  • Increased  the Number of Dedicated resources working for project when compared to their earlier model.

Rejection %

  • Start of Project
  • End of 10 Months

Evaluation Period

Payment Submission %

  • Start of Project
  • End of 10 Months

Evaluation Period