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RCS was built from the ground up exclusively for "small-balance" insurance claims. WE leverage state-of-the-art technology to automate the collection process and very efficiently collect balances far smaller than most hospitals and AR vendors will pursue. We very efficiently pursue both the insurance and patient co-pay portions of claims as low as $25.
Extended Office Services
Extended Office Services (EOS) is our flagship service. Think of EOS as an extension of your patient financial services team, that is empowered with the best software tools in the entire industry to work unusually efficiently (click here for proof that we outcollect the other vendors in head-to-head competition). We quickly resolve the small insurance balances that were too small for your internal team to work and then we efficiently collect the remaining patient balance. Our highly configurable scripts allow us to treat your patients using the exact same words and phrases that you require of your internal team. Our notes on each account transfer in virtually real time to your system, and our services completely adapt to your needs and preferences, making us a transparent extension of your revenue cycle team. Our EOS service is designed to:
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Resolve the insurance portion of the claim quickly, using RCS' proprietary technology for electronically statusing and automatically rebilling claims. |
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Accurately calculate the patient's payment responsibility after the insurance balance has been verified. |
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Communicate quickly and courteously with patients to resolve the claim balance after insurance (including letters and outgoing call cycles). |
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Handle all incoming calls from both insurance companies and patients. |
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Automatically and continuously review claim related activity (payments, adjustments, etc.) and adjust the "next step" on each claim in real time to make sure we are always performing the necessary next steps for resolution. |
The majority of EOS work is completed at our Revenue Cycle Management (RCM) Center with only limited onsite clerical activity. Our proprietary system is fully integrated with all major hospital legacy accounting systems, eliminating the need for onsite space and complicated custom interfaces. Depending on your needs, RCS can work a single payor or multiple payors beginning day one or any age category you choose.
Pre-collection Services
RCS also offers a stand-alone "Pre-Collect" service, that can complete a customer service oriented letter and calling campaign for only self pay financial classes (either patient balance remaining after insurance that the hospital has already collected, or patients who do not have insurance). This includes a custom-designed cycle of telephone contacts to guarantors in tandem with a series of carefully scripted letters. Highly tested and trainied RCS customer service representatives handle all inbound calls. Information received during the cycle, such as new insurance information, is funneled back to the provider for further activity. Again, depending on your needs, RCS can work accounts beginning day one or any age category you choose (i.e., balances after insurance).
Managed Care Payment Review
RCS conducts automated retroactive and concurrent audits of managed care payments to identify underpayments. For underpaid claims, our system automatically produces an appeal letter and claim form and resubmits the claim to the payor for additional payment. Our patient representatives conduct follow-up on the appealed accounts for payment. RCS also supplies the provider with extensive payment variance reporting including underpayments by payor by type.
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