Revenue Cycle Management
Efficient and Effective Revenue Cycle Management
The Revenue Cycle Management (RCM) department at United Urology Group focuses
on the administrative, financial, and business functions involved in the
process of capturing, managing, and collecting patient revenue. RCM ensures
that efficient and effective systems and processes are in place for our
affiliate practices in the interest of generating and maintaining patient revenue.
The processes and systems developed by our Revenue Cycle Management department involve:
- Delivery of an industry low initial denial rate by focusing on clean claim submissions
- Obtaining authorizations and referrals for procedures and visits in a timely manner
- Ensuring the timely and accurate processing of insurance claims
- Reviewing charges received for compliance with Medicare and commercial insurance regulations
- Obtaining and evaluating documentation regarding a medical providers’ training, education, work history, licensure, and regulatory compliance records
- Ensuring the timely posting of payments from all payment sources
- Effectively maintaining and managing accounts receivable
- Utilizing PM and EHR software to adequately track and oversee the claims process from start to finish
Revenue Cycle Management is responsible for the oversight of five areas:
- Credentialing
- Pre-authorization
- Charge capture
- Payment posting
- Third-party accounts receivable