Menu
HCM’s Revenue Integrity & Claims Management services are designed to streamline the entire claims process, from credentialing to claim resolution and denial management. By maintaining compliance, optimizing workflows, and leveraging data-driven insights, we help healthcare providers recover the revenue they are owed while minimizing delays and inaccuracies. Our comprehensive solutions focus on reducing denials, resolving claims efficiently, and ensuring financial accuracy, supporting your organization’s financial health and operational success.
We manage the full credentialing process, ensuring healthcare providers are properly credentialed with payers to prevent delays and denials. Our team oversees payer enrollment, re-credentialing, and compliance management, ensuring accuracy at every step.
We ensure accurate claims submission and remittance processing to accelerate cash flow and reduce errors.
We focus on resolving outstanding claims, starting at 60 days and extending all the way to 365+ days, ensuring no revenue is left behind.
Leveraging decades of payer experience and sophisticated algorithm modeling, our team optimizes denials management to ensure quicker resolutions and higher rates of appeals success. Our focused approach has led to:
Our team ensures the accurate and timely posting of payments to maintain up-to-date account statuses and reduce errors. We process and reconcile payments efficiently to improve financial clarity and operational transparency.
HCM is committed to addressing and resolving all credit balances, regardless of their origin. We thoroughly review and clear outstanding balances, ensuring compliance and maintaining financial integrity for healthcare providers.
Our specialized team manages complex claims, including motor vehicle accidents and workers’ compensation, to ensure proper reimbursement. We handle the intricate details of these claims to reduce the burden on internal staff and ensure timely resolution.
We provide experienced, dedicated staff who are fully integrated into your revenue cycle operations, adapting seamlessly to meet your business office needs through all ebbs and flows. Our staffing solutions ensure consistent support and uninterrupted workflows, precisely aligned with your operational demands.
Human-Powered AI for Enhanced Revenue Integrity: Our approach combines human expertise with AI and machine learning to boost the efficiency and accuracy of revenue integrity and claims management. By harnessing human-powered AI, we leverage predictive analytics that proactively identifies and resolves potential issues, ensuring a seamless and responsive revenue cycle management experience.
© 2024, All Rights Reserved.