Managing Revenue Cycle Processes for Multiple Clearinghouses to a Centralized Single Receiver

Our client’s Clearinghouses and Banks play a key role in how medical claims are submitted and how insurance payors provide reimbursement back to the physician group. Clearinghouse services go beyond just claim submission and remediation. Their services can also include eligibility and benefits checking, referral authorization, and claims status information. Banks provide several key services in the revenue cycle, starting with being the recipient of funds as well as EOBs and Correspondence via lockbox services.

ReMedics BPO services are vendor agnostic, allowing clients to leverage their existing clearinghouse accounts and banking lockbox relationships — while centralizing all of their EOB, claims and correspondence requirements. This includes services for processing payments with data captured from multiple clearinghouses and banks. The technology being used by our Operations Team, known as the ReSolve® A/R Management Platform, facilitates efficient, automated processes with the posting of all remittances; including insurance payments, patient payments, legal reimbursements, clinical trial payments, and others. We also provide for the parsing of EDI transactions for more efficient funds distribution from a corporate receiver to multiple divisions, practice groups or locations.

ReMedics BPO Service Benefits for Complex Environments

• Support a multiple submitter/single receiver approach for complex provider environments
• Use of a single corporate receiver for incoming ERA remits
• Practices can maintain existing Clearinghouse accounts for submission
• Use of a single corporate Bank Account to track and report on all incoming deposits
• Centralized EOB, claim and correspondence capture
• Provides for the splitting/parsing of co-mingled remittance for different business units
• Check Matching for accurate payment posting and reconciliation
• Automated Workflow solutions for PLB Adjustments

Contact ReMedics to Maintain Your Current Clearinghouse and Banking Relationships

Talk to ReMedics about your specific Clearinghouse and/or Banking requirements to manage all of our remittance, data validation and reconciliation needs. We can also help to evaluate your current processes and make recommendations with any proposed changes to your claims management or payment processing. Contact ReMedics online or call 440-671-7700.

Editors Note: Our technology sister company at RCMSLLC.com can provide Hospitals, IDN Health Sytems, MSOs and larger Physician Practice Groups with an on-premise multi-submitter, single receiver posting solution integrated with your EHR/EMR and Practice Management System’s billing applications.