REVENUE CYCLE MANAGEMENT

MedScript helps your practice secure all the revenue you've earned, ensuring you're paid on time and in full.
Our team of RCM experts can manage individual services or the entire revenue process without interrupting your workflow.
Maximize your collections for efficient cash management, higher earnings, and more quality time with patients.

After the patient’s appointment, patient eligibility and benefits are checked with patient insurance to verify that the services that patient will get are covered or not by insurance. Other things like patient co-pay, coinsurance, deductible, prior authorization (if required) are also obtained at this time. After eligibility and benefits verification, the patient gets the services from the doctor at the scheduled time. The services that are given to the patient are recorded on super-bill, EMR or in the form of voice, etc. 

Medical coders review the complete medical records and convert them into codes. This part is very important because to get the payment provider has to send the claim form to insurance that follows specific rules and criteria. On the claim form, patient diagnosis and services provided are mentioned in the form of codes. For diagnosis, the ICD (International Classification of Diseases) coding system is used. For the services and procedures, CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System) is used. A medical coder is responsible for assigning these codes. 

After the charge entry, it’s time to send the claim form to the insurance company to get paid for the services rendered by the healthcare providers.

Claims can be submitted to insurance in three ways.

  1. Paper Claim Submission
  2. Electronic Claim Submission
  3. Online Claim entry on a secure insurance portal
  • Paper claims are submitted through regular or certified mails. The provider or provider’s office fills out the paper claim form and then submits it to the insurance mailing address.
  • For electronic claim submission, clearinghouses are used. In electronic claim submission, billing software generates an EDI (electronic data interchange) file that is uploaded to the clearinghouse. The clearinghouse checks all the claims and sends them to correct insurance with the help of the electronic payer ID. Every insurance has a unique electronic payer ID that is registered with the clearinghouse.
  • The claims can also be submitted through 

Once all the essential information for filling out the claim is gathered, it’s time to enter this data on the claim form or in the billing software. The claim form can be filled by hand or via using the billing software. There are a lot of billing software available in the market with different functionalities.  

Once all the essential information for filling out the claim is gathered, it’s time to enter this data on the claim form or in the billing software. The claim form can be filled by hand or via using the billing software. There are a lot of billing software available in the market with different functionalities.  

A complete claim that follows all the guidelines insurance approved it for payment after reviewing it. When claim gets approved for payment, insurance sends paid EOB (Explanation of benefits) or ERA (electronic remittance advice) along with payment. Insurance companies use different ways to send payment to providers. Some insurances send payment through paper checks, some through electronic fund transfer (EFT) and some paid through virtual credit cards. With every payment, insurance sends an EOB as well. That EOB is posted manually or electronically by the payment posting department.

Let us monitor your income by providing accurate, customizable, and time revenue reports.