RCM solutions across payment models to meet
your unique goals
Our single most important mandate is to prioritize your success. We build lasting partnerships by listening closely and coming up with workable, high-performing solutions that scale
Profession & Facility Fee-for-Service: Cost effective and Comprehensive
<
0
%
Denial rate across all business lines
0
%
First pass rate
0
Decreased AR
days from 40 to
28, accelerating
cash flow
Eligibility Verification
Confirm coverage pre-service to reduce denials
Prior Authorizations
Clear procedures for insurer reimbursement quickly and accurately
Claims Management
Streamline submissions to speed up payments
Denials Management
Address denials quickly to recover delayed revenue
Patient Payments
Simplify collections to boost cash flow
Referral Management
Maintain continuity of care by ensuring appointments are made timely and specialists have all relevant patient information prior to the visit
Option to Deploy Staff Augmentation Services
Dedicated R5RCM Health team members can act as fully-integrated members of an organization’s coding, billing or revenue cycle teams
Value-Based Care: Additional Services
HEDIS Quality Measure Abstraction
Ensure accurate data collection and reporting to meet compliance standards, improve care outcomes, and enhance performance across key healthcare metrics
Retrospective Review
Align patient health status with value-based care premium rate setting, ensuring compliance while maintaining overall financial integrity
Drive RCM Success with Reporting & Insights
Accurate coding and billing are vital to success, but it’s tough to do alone—leveraging external expertise allows managing guideline changes efficiently, ensuring scalability, optimizing costs, and capturing opportunities
Gain Real-Time Insights
Up-to-date data on your financial performance to monitor key metrics and trends
Identify Areas for Improvement
Analytics to pinpoint inefficiencies and opportunities, paired with a plan to improve
Make Informed Decisions
Achieve sustained growth by meeting the demands of a highly regulated industry while keeping costs in check
Why R5 for RCM Solutions?
- Proactive: Early issue detection and real-time interventions
- Expertise: Ongoing provider education and documentation compliance
- Tailored: Customized services for both VBC and FFS models
- Cash Flow: Right-size reimbursements with accurate coding, streamlined billing, and cost-effective workflows
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