Hospitals

Coding is the crucial component of RCM. It’s imperative that rendered services are coded correctly. This includes the appropriate use of HCPCS, Diagnosis Codes and Modifiers. With the vast expertise that our coders bring, we are able to efficiently and accurately code the services in compliance with ICD-10 guidelines. We pride ourselves to have a separate audit team who specialize in comprehensive review of the services coded.

Charge Entry
The main challenge faced these days is of Charge entry and Turnaround time. For our current clients, we have reduced turnaround time for such practices from 72 hours to 24-36 hours. This includes review of EMR/EHR and medical notes. Based on the review, our coders accurately code the charts.

Entry Audits
The most common error while entering charges is Human Error. 3Gen helps reduce this error and increase efficiency. With our current clients, charge entry errors have reduced up to 5%, which helped submit clean claims, reduced denials and lowered A/R days.

Automatic
Current technology makes it easy for all insurances as well as patients to make electronic payments. Electronic Remittances contain high volume of payment transactions. We process the batches and segregate them into denials & payment for further processing.

Manual
Explanation of Benefits (EOB) received via mail are captured in the form of scanned images. The information captured is posted to each patient account and claim.

A/R Calling is of vital importance post claim submission. It identifies the adjudication status of the submitted claim and helps in understanding the claim outcome. Early notification of a denial helps correct the claim at the initial stage and saves it from getting ‘Untimely’ for appeals or corrections.

This is one of the most critical verticals of RCM. A major portion of the revenue is stuck here and requires additional attention. We have a dedicated team for denial management who are experienced in identifying different types of denials and providing corrective action for them. We send out periodic reports to hospitals by identifying common denial types and ways to avoid it for future submission.

There is a portion of revenue that is dependent on Self-Pay or patient payments, which makes patient follow-up very important. We help send out statements on a monthly, quarterly, yearly basis or as per requirement. We generally follow-up with patients on daily basis or as per clients’ needs. This is a value-add service and we call patient on behalf of the clients.