H.H Chen, CEORevenue Cycle Management in healthcare involves many players and systems: providers, patients, insurance payers, clearing houses, and other EHR and PM application providers. The lack of a comprehensive system that can integrate different systems, connect different parties, process, search and store all kinds of data and documents within one place has plagued the RCM process in current healthcare industry. This fragmentation of the RCM process has forced the healthcare providers to perform many unnecessarily cumbersome works such as manual data keying, data searching, document chasing, phone calls, etc. that prolonged AR days, resulted in large amount of un-collected or un-applied cash, erroneous payment data, denials, underpays, or even missed payments. CereSoft—a Maryland based RCM system and service company provides a platform leveraging their unique intelligent document and data processing and technology to provide a cloud based system to process, validate, post, store and search all claims, remits and payment data, converting them all into the standard electronic format compatible with HIPAA and acceptable to all PM or patient accounting systems. “Our revenue management platform caters to the healthcare industry’s demands to deliver an integrated claim settlement solution,” begins H.H Chen, CEO, CereSoft.
CereSoft offers its flagship RCM product suite—MedAR and the accompanying services. With this platform, clients will reduce significantly the time required for data-entry and its follow-up work. “Our system being cloud-based enables clients to access the claim and payment data anywhere anytime with high accuracy and reliability. This is highly valuable to our clients,” affirms Chen. “The platform archives the data in the cloud which allows healthcare providers to track and retrieve all electronic and image documents and data regarding payment through its full search capability within a single system,” says Chen.
If a healthcare provider organization has many different hospitals, offices or doctor groups, MedAR will split the RCM documents and data and allocate funds to each branch or group separately and still maintain balances and reconciliations to help the organization to track the flow of its daily receipts.
Our platform processes data in real-time and provides daily updates to enable clients to identify payments received from patients, insurance payers, or bank Lockboxes
CereSoft’s Claim Center and online EasyPay Portal is also available within MedAR that enables the providers to connect directly with the payers and patients within a singular view and touch.
CereSoft also provides a powerful denial management solution integrated into MedAR Online System. The denial management will identify the denied claims, provides appeal letter templates, map denial categories to individual workflows for appeal and will track the history of its status. “This is the only denial management that will view, process and track denials from all paper and electronic sources including the EOB, ERA and paper or fax correspondences,” says Chen. Using the same platform, other follow-up tasks such as underpayments, recoupments and refund requests are handled similarly.
“The immense knowledge we have gathered from our RCM services enables us to analyze data that most vendors are incapable of,” says Chen. The company looks forward to expand their market segment to the mid and smaller-sized practice groups who have minimum resources and personnel at their disposal. “We are also empowered to offer our solution outside the healthcare such as banks to streamline the full payment and AR process for their business clients,” concludes Chen.