RCM
Our Services
Pre Registration
- Registering before the Date Of Service
- Admission
- Patient‘s Personal, Insurance and Employer
Information - Pre Registration Rep may call patient for info
- Patient can Pre Register in the Hospital’s
website(Possible)
Registration
- The process of gathering comprehensive and accurate Patient Demographic
and Payer Information for services to be provided in the Hospital - If information has been gathered already through Pre-Registration, then it has
to be varied in this stage - Assignment of Benefits
Charge Capture
- Charge Capture is the process by which Procedures
and medication extended to patients are recorded,
coded, priced and billed - Charge Description Master (CDM) is a le that
contains all charges with the corresponding prices
Medical Records (Coding)
- Department responsible for maintaining Medical Records
- Major activities of the department – Coding (Click for More information) – Transcription – Release of Information
Claims & Transmission
- Printing Paper Claims & Sending them to Payer
- Transmitting Electronic
- – Claims to Payers
– Clearing House
– Scrubber
Payer & Vendor ID
– Edits
Cash Posting
- Posting Payments for the respective accounts
(from the EOB) - Identifying Denials / Low Payments
- Identifying Over Payments
Accounts Receivables
- Analyze Insurance / Patient Balance Accounts
- Follow Up with Insurance / Patients for Resolving
Accounts - Take necessary action on Accounts
Collections
- Collecting Patient Balances that could not be
addressed / resolved - Collections could be done by the Hospital or by a
Collection Agency appointed by the Hospital
Security & Compliance
At Forecast Healthcare we continuously strive to maintain exemplary ethical
standards and implement the highest level of compliance in employing physical,
network, and process security measures. We ensure strict adherence to HIPAA
(Health insurance portability and accountability act) rules.
Credentialing & Enrollment Management
A one-size-its- all approach does not work for credentialing and enrollment as each practice comes with its unique set of challenges. Let our experienced team specialist help you cut through all the red tape and time consuming paper work.
Once we collect your information we get to work immediately and do the rest until it is complete and you are 100% satisfied.
Physician Credentialing and Enrollment Solutions
- Medicare and Medicaid provider enrollment and credentialing.
- Commercial insurance provider enrollment and credentialing (Aetna, Anthem, BCBS, CIGNA, Humana, TriCare, United Healthcare, and many more).
- Medicare revalidation.
- CAQH registration.
NPI registration (Type I and Type II). - Reimbursement issues.
- Managed Care contracting issues.