Revenue Cycle Management (RCM)

Insurance claims represent a cash flow lifeline for health care providers. However, many offices are not staffed or trained to effectively handle claims processing. DataMax’s RCM Division serves as a seamless extension of your office that can supplement your internal staff and provide a full range of outsource services.

Our experienced RCM team will help your staff become more efficient, productive and profitable. Our goal is to provide 100% claims resolution.

Our RCM team is remarkably experienced across a wide variety of medical specialty areas and practice management software systems. Our clients include hospitals, large and small group practices, and clinics.

A partnership with RCM results in improved processes, higher revenue for your practice, and a positive experience for your patients.

Revenue Cycle (as defined by the Healthcare Financial Management Association) is “all administrative and service functions that contribute to the capture, management and collection of patient service revenue.” The term incorporates the entire life cycle of patient accounting from creation to payment. Effective revenue cycle provides a steady stream of income. When problems occur anywhere in the process, time and dollars are lost. Teaming with DataMax ensures reliable and predictable results.

RCM can assist with all aspect of back office insurance processing:
  • Certified Professional Coders
  • Credentialing
  • Pre-Collect patient calls
  • Account reconciliation
  • Verification of eligibility and benefits
  • Mail processing
  • Secondary claims
  • Appeals and denials
  • Insurance billing
  • Payment posting
Our Value Proposition to You:
  • Optimize Cash Flow
  • Mitigate Risk
  • Control Costs
  • Reduce A/R
  • Enhance productivity and efficiency
  • Temporary help during staff or system transitions
  • Provide Quality customer interaction
  • Offer Staffing Flexibility
  • Established Local presence (All operations in Winston-Salem)
  • Enhance patient relationships
  • Provide billing solutions
  • Experience with a variety of practice management systems
RCM works seamlessly with our clients to:
  • Resolve outstanding claims
  • Monitor claim statuses
  • Contact physicians, patients, insurance companies and hospitals to obtain correct information
  • File and follow up on appeals and reconsiderations
  • Submit and/or correct claims on-line (when available)
  • Post EOB’s, update patient and insurance information
  • Transfer balances to patient pay after claim is resolved (when appropriate)