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Streamlined Revenue Processes for Hospitals

End-to-end hospital revenue cycle services — accurate registration, complete charge capture, UB-04 coding, denial management, and performance dashboards for hospital leadership.

Registration Chargemaster ICD-10 / UB-04 Claims Submission AR & Denials KPI Analytics

Full-Service Delivery

Patient Registration & Insurance Verification

Accurate capture of demographics, insurances, prior-authorizations and eligibility before service.

Charge Capture & Chargemaster Maintenance

Complete capture of all billable services, procedures, supplies, labs and diagnostics, aligned with hospital chargemaster standards.

Coding & Compliance (ICD-10 / CPT / UB-04)

Certified coding, coding audits, modifier application, compliance with payer and regulatory rules.

Claims Submission & Tracking

Electronic & paper claim filing, follow-up, remittance processing, and ERA reconciliation.

Payment Posting & Reconciliation

Accurate posting of payments, adjustments, patient balances, and credit-balance resolution.

Denial Management & Appeals

Investigation, correction, resubmission or appeal of denied or rejected claims to maximize collections.

Accounts Receivable Management

Proactive follow-up on outstanding claims, aging analysis, patient collections, and AR dashboards.

Credit Balance & Refund Resolution

Identify overpayments or patient credits, correct balances, and manage refunds or write-offs.

Reporting & Analytics / KPI Management

Comprehensive financial reporting, denial trend analysis, claim cycle metrics, cash-flow forecasting and performance dashboards.

A Structured Workflow

01

Pre-Service

Verify insurance, benefits, prior-authorization requirements before admission or service.

02

Registration

Capture all required patient information and payer details accurately.

03

Coding

Document all services, procedures, supplies, diagnostics — code accurately using ICD-10, CPT, UB-04.

04

Submission

Submit claims electronically or via paper; track through adjudication.

05

Posting

Post payer remittances, patient payments, adjustments, balances.

06

Denial Resolution

Analyze denials, correct documentation or codes, resubmit or appeal to recover payment.

07

AR Management

Monitor outstanding AR, follow-up, refund credits, and close out accounts.

08

Reporting

Provide dashboards and KPIs — cash flow, days in AR, denial rate, revenue capture, and forecast.

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