One of the key components in the strategy of any organization is maintaining its cash-flows. In the US Healthcare industry, it all depends on Healthcare Revenue Cycle Management (HRCM).

Truworth is an offshore full-service Healthcare Revenue Cycle Management company providing customized a-la-carte services to its clients in the US market. At Truworth we classify our HRCM service offerings in to:

FRONT OFFICE
Appointment Scheduling
• Agents can schedule over the phone
• Can design systems for patients to schedule via Internet
Eligibility Verification
• Know the eligibility before the service
• Bill patient for the visit if not covered
• Get pre-authorizations as needed
Reminder Services
• Appointment reminders by agents/recorded messages over phone, text messages, fax or email

MIDDLE OFFICE
Medical Transcription
• Can be a new revenue stream for billing companies
• Can be offered to clients not using EMR
• Can also be offered to clients using EMR but not wanting to type out themselves; dictations can be converted to EMR
Medical Coding
• Coding from charts & transcripts
• ICD, CPT & HCPCS coding with modifiers
• Manual checks for CCI edits, LCDs, LMRPs

BACK OFFICE
Charge Entry
• From coded transcripts or scanned super-bills
• Charge Review including unbilled & exclusions
• Claims Inspector resolution
Claim Submission
• Electronic batch submission
• Paper claims printing & mailing
Day Close Procedures
• At a fixed time before US shift starts
• Daily reporting of charges, postings & write-offs
EDI Verification and Resolution
• Rejected Claims
• Returned Claims
• Returned patient claims address resolution Payment Posting
• From EOBs scanned into the system
• From Electronic Remittance Advice (ERA)
Denial Posting with notes
• Posting of all denials and zero payments with detailed notes to facilitate follow-up
Insurance AR Follow-up
• Using the web
• Over the phone
• Not just follow-up but resolution
• Corrective actions and immediate Resubmission electronically or by fax
• Preventive actions – Suggest changes in the billing process
• India side can even follow-up on small dollar value claims which are generally written-off
Patient Statement Generation
• Generation & Verification of Patient statements
• Customized messages on statements
Patient AR Follow-up
• Payment reminders by phone & fax
Exception reporting