Revenue Cycle Management: What Matters Now, Part 3 of a 6-part series. View podcast and key topics at www.alnmm.com/rcm-series

1. Revenue Cycle Management: What Matters Now
Technology Enhanced RCM
Guest Host
Tim Griffin, Tim Coan,
COO CEO
ALN Medical Management ALN Medical Management

2. Getting the Foundation Right
A robust practice management system is the platform
for a high performing revenue cycle process
Integrated
With EMR
Workflow and External
Enabled Systems
Ease of
Use and
Productivity
Standards
Compliant

3. Reimbursement Maximizing Technologies
Appointment scheduling Automated appointment reminders via phone, email,
and/or text messaging
Skip tracing Checks demographics for all/some of self-pay and high-
dollar patient liability claims
Electronic eligibility and Checks select scheduled visits (inpatient or outpatient)
benefit verification to confirm insurance information, benefits, and
authorization requirements
Pre-adjudication claim Tool based on payer edit rules to identify errors in
scrubbing claims prior to billing
Denials management Provides grouping, work queues, routing, and reporting
Card Scanner Attach digital image of insurance card to patient record
Card on File/Patient Enables patients to pay bills online electronically and/or
Payment Portal setup automated payment plans
Charge Capture/Coding Eliminates missing charges, improves coding accuracy,
and simplifies billing workflow

4. EDI Process
Provider Payer
Eligibility Inq (270) Subscribe/ Patient
Patient Information
Information
Eligibility Resp (271)
Prior Authorization Review Req (278) Prior Authorization
Referral/ CMN Referral/ CMN
Review Resp (278)
Claim (837) Prior Authorization
Claim/ Encounter
Remit Advice (835) Referral/ CMN
Status Inq (276)
Status Resp (277)
Claim Status Claim Status
Extra Info Req (277)
Claim Attach (275)

5. Keeping A/R Low
 Quick and accurate payment and denial posting
 Electronic Remittance Advice where possible
 Denial code classification and analysis
 Patient payment processing solutions

6. Actively Manage Follow-Up

7. RCM: What Matters Now
Why RCM
Performance is
More Important
Than Ever
Interoperability:
Managing Day
The Coming
to Day RCM
Merger of
Performance
Clinical and
with Data
Financial Data
Revenue
Cycle
Management
RCM
Reporting: Technology
What to Watch, Enhanced RCM
When to Watch
The Future of
Coding and
Compliance