Revenue Cycle Management

From start to flourish, 360° Revenue Cycle Management

Expertise and Specialization

Our team of RCM professionals brings years of healthcare industry experience and expertise.

Customized Solutions

We tailor our services to meet the unique needs and goals of each healthcare provider.

Technology Driven Approach

We deliver excellence by leveraging technologies like automation and data analytics by improving efficiency and accuracy considerably.

Compliance and Security

Since we are a healthcare focused organization from beginning adherence to regulations and safeguarding patient information is in our DNA. We are a SOC 2 Type II, ISO-27001 certified, and a fully HIPAA compliant organization, committing to a 100% work-from-office policy, we maintain the highest degree of client information confidentiality and data security.

At AM Infoweb, we are committed to delivering EXCELLENCE in revenue cycle management solutions, meticulously crafted to align with the distinct requirements of each organization. Recognizing that every entity possesses unique objectives, we tailor our strategies accordingly. With a deep understanding of the complexities and challenges of the healthcare landscape, our dedicated team of RCM experts leverages industry-leading practices and cutting-edge technology to optimize your financial operations. From accurate coding and billing to proactive denial management and patient-centric collections, we empower healthcare organizations to maximize revenue, enhance efficiency, and ensure compliance while boosting over all patient experience.

Front-end Revenue Cycle

Patient Scheduling & Registration
The trained experts in AM Infoweb help systematically coordinate and organize patient appointments within a healthcare facility. This encompasses the entire process, from initial appointment scheduling to confirmation, rescheduling if necessary, and ensuring accurate recording of patient information.

Insurance Eligibility and Benefits Verification
This is the process of confirming a patient's insurance coverage and understanding the extent of their benefits to ensure accurate billing. It is crucial for healthcare providers to avoid claim denials, streamline reimbursement processes, and provide transparent financial information to patients.

Prior Authorization
Our team makes sure to obtain approval from an insurance provider before a patient receives specific medical services or consultations, ensuring coverage and preventing potential claim denials.

Patient Demographics
We make sure we collect and record essential information about a patient, such as personal details, contact information, and insurance data, to establish accurate records and facilitate seamless claims submission and error-free billing.

Healthcare Call Center
With flawless accent and communication, we deliver an extraordinary experience for your patients. We serve as a centralized communication hub, handling inquiries, appointment scheduling, and providing support to patients, healthcare providers, and other stakeholders to enhance overall operational efficiency.

Mid Revenue Cycle

Charge Entry and Charge Audit
Accurately recording and entering charges for the medical services provided, while Charge Audit is the process of reviewing and validating these entries to ensure compliance, accuracy, and optimal reimbursement.

Medical Coding Services
Our certified medical coders assign accurate codes to medical procedures, ensuring timely reimbursements and reducing claim denials.

Clinical Documentation Improvement
We assist in enhancing clinical documentation to strengthen precise coding, reduce claim denials, and ensure adherence to regulatory requirements.

Revenue Integrity
We contribute to maintaining revenue integrity through consistent audits and assessments of billing processes and claims submissions.

Medical Coding Audit
Our team conducts medical coding audits to pinpoint and correct errors, ensuring prompt reimbursements and minimizing claim denials.

Back-end Revenue Cycle

Payment Posting and Reconciliation
Our data management team efficiently logs correspondences, processes charges, conducts audits, and directly posts EOBs and ERAs into your billing system. Additionally, we manage patient balance transfers and secondary billing according to your specific requirements.

Accounts Receivable Management and Collections
With over 15 years of experience, our team excels in managing accounts receivable, employing proven best practices to ensure timely follow-up and effective collections.

Denial and Appeals Management
We expertly manage rejected claims by comprehensively managing the appeals process, rectifying discrepancies, and resubmitting claims to maximize reimbursements and minimize revenue loss.

Underpayment Analysis and Recovery
Our team of specialists excels in identifying payment discrepancies, analyzing root causes, and implementing strategies to secure full and accurate reimbursement for healthcare services rendered.

Credit Balance
We administer credit balance accounts, ensuring timely and accurate refunds to foster positive relationships with patients and insurance providers.

Consultative Support

Provider Enrollment and Credentialing Services
Our team handles provider enrollment and credentialing, ensuring strict compliance with regulatory requirements and facilitating smooth reimbursement processes.

Revenue Cycle Process Automation
We identify automation opportunities in your operations, and our expert developers, well-versed in AI and revenue cycle management, help enhance operational efficiencies and provide valuable data analytics.

Customer Contact Center
Our extensively filtered associates, with specialized training in accents and cultural nuances, ensure a superior customer experience by handling inquiries, facilitating payment arrangements, and enhancing overall customer satisfaction.

Case Study

Innovative RCM Strategies helped Healthcare Provider to Exceed EBITDA Targets with AM Infoweb

The leadership team of a healthcare provider company, had a task at hand from their private equity investor to meet a specific EBITDA target within the next two quarters. The most effective....

Client Info

The clients providing services in Florida, California, Texas, Arizona, Nevada, Utah, and Puerto Rico.
They deliver advanced care from expert clinicians by meeting patients where they are.

Challenges & Solutions

AM lnfoweb helped the healthcare provider tackle their unresolved claims, resulting in decreased Accounts Receivables and enhanced resolution rates among other benefits.
The synergy of specialized knowledge, intellectual automation, and efficient operations significantly aided the provider, effectively addressing their challenges.

Challenges	Solutions
Unresolved Claims - Our partners encountered challenges with unresolved claims in accounts receivable (AR) exceeding 90 days, comprising approximately $ 4.34 Million in unresolved claims that proved difficult to effectively manage the operations with their internal team.	In two months, we reduced greater than 90 days bucket in AR from $ 4.34 to $ 3.25 million using effective communication tools, payer portals , and CRCS-certified AR collectors, enhancing efficiency and revenue cycle management.
Underpaid Claims - Receiving payments lesser than the contract rates from payors	In our preliminary review of settled claims, AM Infoweb identified over 1,700 inaccurately compensated claims, totalling more than $204,000. We coordinated with the provider relations team on the payer's end and, through ongoing communications, were able to fully recover all underpaid claims.
Net Collection Rate (NCR), First Pass Ratio (FPR), and Clean Claims Rate (CCR). - Their NCR, FPR, CCR was less than 95% due to inefficiency in implementation of collection process and challenges in claims with huge outstanding balances.	We've maintained a steady 95% Net Collection Rate (NCR), First Pass Ratio (FPR) , and Clean Claims Rate (CCR). This was achieved by effectively working on timely follow ups, Maintaining a rigour and working on rejections and denials establishing a communication grid between AR and other departments to ensure timely updates from AR being followed by the other departments.
Sending Patient Statements And Collecting Balances - Incorrect management in sending patient statements and subsequent balance collection	From $700,000 to now less than $350,000 in patient collections within a span of 2 months, the team adhered to structured follow up methods based on the Fair Debts Collection Practices Act (FDCPA)
The Resolution Rate - The Resolution Rate of AR Collectors fell below 80%	We helped them increase their Resolution Rate from less than 80% to now at 97% as we hired the associates with the necessary CRCS certification by AAHAM. The associates followed the updated SOP rigorously with seamless communication with the insurance counterparts.
Referral and Authorization - With over 50% of rejection ratio in the authorization and re-authorization of services. Resulting in burdening the patients.	Currently with the robust protocols and process improvements in place the rejection ratio has dropped from 50% to 10%. This was made possible by 100% live audits, which then was followed by real-time feedback and frequent training workshops for the associates.
Quality Management System - The clients were lacking the Quality Audits aspect from their day to day operations.	Currently with 99% accuracy, the quality of operations have reached to a better optimized stage. We have adopted the DPO methodology for non-fatal defects and DPU for fatal errors.
Denial Rate - The client faced a denial rate of over 43%	By implementing 3 step disposition method to pin point the denial and its root cause which eventually helped in reduction of denials from 43% to 10% in 2 months which is currently at 4%