Revenue Cycle Management

Revenue Cycle Management Services

We streamline your systems processes and people, to enhance your revenue cycle with our industry expertise combined with digital capabilities. Stars Pro is a complete one-stop solution for revenue cycle management services powered with advanced technology, robust systems, and insightful business insight. Established in 2018, Stars Pro is a competent expert in Revenue Cycle Management Services towards better cash flow, supportable services to patients, and business feasibility. Powered with the latest skills in the healthcare revenue cycle, we specialize in minimizing bad debt and increasing revenues.

As a healthcare provider, your practice needs to maintain the balance between providing treatment to patients, filing claims to insurances and getting them paid. This process is amalgamation of healthcare, business motives and administrative procedures with insurance companies. It is a compound series of steps involving, coding, claims, registrations, collections, remittance, and follow-ups. It is often these boring and cumbersome tasks that hamper you from focusing on your core Healthcare business. Healthcare providers often capitalize more resources and time in achieving their goals while a professional revenue cycle management partner can deliver you better results. Revenue Cycle Management services are at a spiraling growth due to their return on investment and the optimized business methodology. Nearly all major players in healthcare are utilizing these advanced methods to better revenue streams and lesser bad debt. The transition from traditional services fees to reimbursement-based healthcare has remodeled how healthcare providers are functioning in terms of better financial feasibility.

Offering healthcare to patients is a revenue stream but when hospitals spend more resources to recover that revenue, it isn’t an added value. A healthy and professional RCM system can be an effective business move that helps you thrive in the competitive market scenario.

An effective and proficient RCM system is functional for a multitude of factors

  • Enhanced Revenue and cash flow system
  • Upgraded processes and procedures to suit business needs
  • Effective clinical, administrative and revenue generation functions
  • Staying updated with CMS Guidelines

How Stars Pro Delivers Leading Edge RCM Services

  • Extensive experience with healthcare billing companies with proficient system diagnostics
  • Real-time processing of Insurance Eligibility Status of patients
  • Accurate Review and scrubbing of claims
  • Creation of self-pay, e-statements and submission to online service
  • Eliminate regulatory and compliance hassles
  • Effective follow-up of claims from Insurance companies.
  • Reconcile all accounts and address issues related to patient liability and adjustments
  • Strong management of underpayments and denials
  • Productivity accuracy in payment posting and minimized credit balances

What makes Stars Pro the Ideal Choice

Equipped with leading-edge Medical Billing services, we are streamlined for end-to-end processes and reporting tools, the majority of the claims are resolved within 90 days. You can rely on our expertise in RCM services and focus your resources on your core business.

Our RCM Service Flow

Eligibility/Deductible Verification

Insurance eligibility / deductible verification are the most important and the first step in the medical billing process. Insurance eligibility verification directly impacts the reimbursement. Insurance companies regularly make policy changes and updates in their health plans. Therefore, it is important for the medical billing company or the physicians to verify if the patient is covered under the new plan to get maximum reimbursement. Confirming the insurance coverage facilitates acceptance of the claim on the first submission, whereas non-verification leads to several discomforts like rework, reduced patient satisfaction and increased errors other than causing delays and denials.

Verification Process

Verify patients’ insurance coverage with insurance by making calls to the payers and checking through their authorized online insurance portals.

Update the medical billing system with eligibility and verification details such as member ID, coverage period, co-pay, deductible, co-insurance, cap limit and other code-level benefits information including max allowed limits.

In case of issues regarding a patient’s eligibility, we inform the client immediately. This process increases clients’ monthly revenue and reduces rejections and denials.

Coding and Billing

It is important that correct coding and billing practices are executed by all professionals and physicians. They must have CMS certified EHR and training about the system to equip themselves for correct codes with ICD-10. As the coding system is complex, experienced professionals are required for processing claims on the first submission.

Super Bill Completed by the Provider

Accurate billing is essential to RCM efficiency and Stars Pro had devised steps to execute it. The physicians are required to get reimbursed as per the services and information needs to be entered correctly. We employ control measures, so that diagnosis, procedures, and services are billed appropriately to the insurance companies.

Claim Processing

Any sort of claims denials and rejections will add up to lost revenue for the healthcare center. Excessive delays in reimbursements also affect the cash flow. To combat these problems, it is critical that each step of the workflow is bench-marked for accuracy and better processing. Complete staff including providers, front desk, billing staff, coders and clinical staff must be trained for understanding their role in claims processing.

Patient Payment

We fully understand the nature of the healthcare business. Although we focus on copays at registration time itself, in certain instances it may have to be altered. As healthcare practices face rush hours and emergency situations, we have devised adequate procedures to combat such circumstances.

  • Accurate claims and data processing are cardinal to coding and billing in the process. It is a prerequisite that claims get accepted and it will determine the revenue generation.
  • Accurate data entry and timely submission will ensure a higher claim acceptance rate.

Payment Received

The final step of RCM cycle is the receipt of payments. Receiving payments is essential to the business existence and any denials may be informed by ERA/EOB. The Claims processing cycle is burdensome and having a proficient RCM partner can make things hassle-free.

Maximize your Account Receivables (A/R)

We minimize your lead time and let you process clean and accurate claims. As a healthcare provider, tasks like submissions, inaccurate data, and claim settling takes excessive resources and time. Stars Pro will let you have dedicated professionals for your billing and ensuring expedite reimbursements.

With a significantly high first-pass claim acceptance rate, we optimize A/R. When it comes to claims processing, we have got you covered.

We Specialize in Becoming Your True Billing Partner

Stars Pro RCM collaborates with your Medical Practice and acts as your Billing Partner. We plan and implement our services by customizing it for your medical center.

Our team works closely by evaluating your specific requirements to ensure you get every claim paid. We are experts in monitoring and optimizing your system and A/R that has a direct effect on your revenue collection.

We have proven strategies and systems in place that adds value to your business. We act as a liaison for you at every step of the RCM cycle by incorporating advanced technology.

Many tasks are automated and give you supreme accuracy and optimization. Our primary goal is to increase your revenue stream and minimize bad debts.

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