Revenue Cycle Management (RCM) services form the backbone of a profitable medical practice and play a pivotal role in assuring the profitability and sustenance of any healthcare provider. Claim submissions account for $4.5 billion of the total healthcare spending in the US which is 13% of the entire administrative transactions.
Optimizing end-to-end automated RCM is a key concern for healthcare providers to remain profitable, provide high-quality patient care, and deliver positive patient health outcomes.
The process starts from patient registration, billing, and autonomous medical coding to payment posting. Our solutions combine the power of hyperautomation combined with extensive expertise and experience to simplify the patient experience on the front end, streamline back-end operations, and ensure compliance with industry standards and best practices.
We assist in simplifying patient experience on the front end, expediting back-end processes, and guaranteeing adherence to industry standards and best practices by combining the power of hyperautomation with significant knowledge and experience.
Hyperautomation Potential in RCM Heatmap
JK Tech’s Hyperautomation Solution for RCM
Autonomous Medical Coding
- Converts unstructured clinical text to structured information, mapped with ICD 10 ontologies.
- Filters code and suggest correct code with audit trials using trained AI/ML models.
- Orchestrates the workflow that validates and automates the coding of the records.
Patient Registration
- Streamline the front-end intake process by automating the data capture process electronically.
- Enable integration for real-time eligibility verification and automated patient check-in.
- Leverages AI model to scan and extract information data from driving license and insurance card into the practice management system.
Charge Capture & Claims Submission
- Extraction, classification, review, validation, and export of information from the super bill.
- Processing of extracted information through an advanced in-built coding engine for recommendations in case of any medical coding errors.
- The claims contract-based fee schedule price estimator analyses procedure codes against historical data. This helps in deriving expected payment, proactively detects errors before automated medical claims processing, and reduces the chances of claim denial.
Charge Posting
Hospitals and medical practices can profit from faster cash flow for charge posting with a clean claim record of about ~90%.
- Extract, classify, review, validate and export information from the super bill.
- The extracted information is processed through an advanced in-built coding engine to recommend in case of any medical coding errors.
- The claims contract-based fee schedule price estimator analyses procedure codes against historical data, which helps derive expected payment and proactively detects errors before claim submission, reducing the chances of claim denial.
Payment Posting
Automating payment posting can increase gross recovery and net collection rates by 25%.
- Developing practice and physician-specific business rules, accurate payments, adjustments, and write-offs, managed through cognitive data extraction capability.
- The in-built reason code analyzer alerts human agents when bundled payments are identified in the EOB.
