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Revenue Cycle Management

With the growth in high deductible health plans (HDHPs) and copay amounts increasing the burden on patients leading to defaults, providers face several challenges in receiving reimbursements for services rendered. 

Payers are also imposing strict rules with value-based contracts and P4P becoming the norm, forcing providers to change the way they bill and submit claims for their services. Continuously increasing hospital costs is adding to the financial burden on hospitals. Moreover, improving patient experience across the various touchpoints in the RCM process and meeting pricing transparency requirements is a new area to focus on now. With providers grappling with so many challenges, Coforge healthcare consulting team can assist in improving your RCM operations by leveraging the power of automation and AI/ML in:

  • Improving revenue collection through chargemaster management and adoption of AI in claims coding
  • Claims validation, generation, and submission
  • Revenue reconciliation & Account Receivables management
  • Reducing Claims Denials and Managing Appeals & Grievances 
  • Enhancing Patient experience during registration, eligibility verification, billing, and payments
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