RCM Scope of Services
Front End: Charge Capture, Claims Submission, EDI Management
We integrate our billing system with multiple EMRs and intelligent claim scrubbers to automate more of the charge capture process. Our robust front-end submission system helps us increasingly identify claims that will deny so they can be corrected before they are submitted.
Middle: Claim Status, Payment Posting, Denials Classification
Our automation applied to the middle of the revenue cycle increases accuracy, speeds the time to payment, and accelerates getting denials appealed and paid.
Back End: Payer AR Management, Denials, Resubmissions, Appeals
We are early adopters of machine learning to predict denials. We automate much of the transaction work so our staff can work on claims not paid correctly the first time. This leads to superior collection results.
Patient Responsibility: Statements, Patient Calls, Payment Plans
We send patient statements, balance reminders, field in-bound calls in our US-based call centers, administer patient payment plans, and manage the integration with various emerging mobile patient payment technologies.
Reporting and Analysis: Standard and Custom RCM Reports, Insights about the Business
Our business intelligence and analytics capabilities allow our clients to have great visibility to RCM performance and extract real actionable insights about their business from the data that flows through the revenue cycle.
Compliance: RCM and Coding Compliance, Data and System Security
We take our responsibility to help ensure our clients’ compliance with various healthcare regulations seriously. Likewise, we protect our clients’ data in multiple ways that an individual practice could never afford if managing their systems in-house.
Technology Management: Hosting, Application Interfaces, Data Exchange
There are an increasing number of complex technologies that must come together to enable a high performing revenue cycle. We have extensive IT skills to manage and optimize these disparate systems for our clients.
RCM performance is about getting paid what you should, when you should. Our people, processes and technology are geared toward maximizing payment for your work.
Too often, software vendors or offshore companies who have entered the RCM business think all that matters is technology. With ALN, you have known and knowledgeable people all actively engaged with you and your practice to do this work together.
The revenue cycle gets more complex every day. We believe the answer is to operate with you in a very above-board way, sharing clear RCM performance data and working together to improve it.
Your practice is unique, so ‘one-size-fits-all’ models don’t work. We are agile and bring expertise, creativity and options as we collaborate with you to find effective, practical solutions to solve your problems.
We do more than just work claims. We also provide actionable insights from your RCM data to help you navigate through the challenges facing your business.
Client Service Team
Each strategic client has an assigned Client Executive who is actively involved with our clients to ensure that we are maximizing our performance for the client.
Our RCM Directors mange our various billing teams and oversee the RCM metrics, providing the operational connection and communication with our clients to continuously improve performance.
All new clients are guided through a detailed start-up process by a project manager and our entire onboarding team to ensure a smooth transition to ALN.
The day to day claims processing and AR management work, from submission through payment, is managed by the Billing Manager and team assigned to each client.
Our US-based team sends out patient statements, supports electronic patient communication, fields all inbound calls related to their bill, processes payments and administers patient payment plans.
Provider Enrollment Team
Our specialists work with our clients to submit and manage the enrollment applications of their providers with various third-party payers.
IT Support Team
Our technical team provides 24/7 support to our clients for the systems provided by ALN and the integration to other applications.
Our standard reporting is organized around four primary areas in order to give our clients a fully rounded view of their revenue cycle and their business.
These measures show collections performance against projected cash flow. The expected collections are determined by a sophisticated algorithm that incorporates specifics of the claim, payer allowable amounts, and historical payments.
2. Billing Operations
The metrics assess the performance of key aspects of the billing process from start to finish as claims and AR move toward full resolution.
These measures of upstream production volumes provide insight into the services performed by providers – by provider type, location, visit type, coding, and RVUs.
The data help our clients understand how their work was actually compensated, providing multiple views of the reimbursement analysis – by payer, provider, procedure and visit types.
In addition to our standard reporting, our Business Intelligence team provides deep and sophisticated custom analysis to support our client’s specific business questions.
ALN utilizes billing systems from market-leading providers of practice management software, which we have been optimizing for over 15 years to increase the results for our clients.
Robotics Process Automation and Artificial Intelligence
We are investing extensively in the continuing automation of repetitive tasks, standard rules, and predictive analytics to improve the quality and results of our RCM process.
We have integrated our billing platform with multiple EMR systems, allowing our clients to leverage the ALN RCM engine while using the EMR solution most suitable for their specific needs.
Our systems and client data are housed in a top tier data center that provides our clients with a level of protection and security far beyond what most practices could afford alone.
ALN’s IT team manages our client support needs for the applications provided by ALN. We work on our client’s behalf to help integrate data from other applications.
Our team has the technical ability to develop and manage all interfaces between the ALN billing platform and other systems used by our clients.
In response to the threats to protected data, we have invested heavily in the protection of our client’s data and in multiple levels of disaster recovery.
RCM White Papers
RCM Best Practices
Enter your name and email below to download a checklist that outlines priority RCM performance measures and the critical success factors that distinguish superior performers.RCM Best Practice Checklist
The Big Question
Enter your name and email below to download a whitepaper that addresses the number one question when it comes to the revenue cycle: How are we paid compared to how we should be getting paid?The Big Question