Revenue Cycle Management

Overview

Innoval Global Solutions has empowered its expertise to cater to businesses of all kinds with efficient Revenue Cycle Management solutions. These solutions are blended into Operations only after a thorough evaluation against existing challenges in the industry and obtaining satisfactory results. Existing clients at Innoval Global recognize and value the services delivered across RCM in their businesses.

Innoval possesses excellent knowledge working both professional and institutional businesses. Services are offered after examining the actual health and need of the business, with an estimated acceleration in cash.

Let’s review some of the major service offering at Innoval Global Solutions:


Medical Coding

With extensive experience applying CPT, ICD-9-CM, ICD=10 and HCPCS Level II codes correctly to claims, the team at Innoval Global Solutions can be trusted to manage your medical coding. Innoval has the flexibility to allow you to augment the coding department or handle thousands of daily transactions rapidly and accurately. Special expertise in ambulatory, emergency department, wound care, and radiology coding demonstrate proven success.

Innoval global Solutions' medical services include:

cash

Optimizing revenue by reducing compliance risk

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Improving cash flow by accurate claims submission

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Reducing administrative costs

Innoval’s coding services are available as part of our Revenue Cycle Management service package or as a stand-alone service.


Eligibility Verification of Insurances

Increase patient satisfaction by verifying insurance quickly and accurately at the beginning of your conversations. Trust Innoval’s multi-faceted approach to clearly and considerately communicate with patients. Using the latest internet-based or traditional paper systems, Innoval collects insurance information from your patients quickly and accurately to gather a greater proportion of balances owed earlier. Let’s take a look at just a few of the feature possibilities in Innoval's Eligibility program:

  • Image Patient Registration
  • Image Data Enrichment
  • Image Encounter Documentation

Claims filing and follow up

Leave navigating insurance claim management to the experts at Innoval Global Solutions. Leverage our extensive experience working with medical payers and concentrate your resources where you need them most. Whether it’s following up with electronic transactions using EDI 276/277 per ANSI 835/837 or handling Medicare and Medicaid CMS 1500 and UB4 service forms, the team at CRM can streamline your revenue cycle.

An important part of the RCM process is Medical Claim Scrubbing. Claim rejections happen mostly due to human errors due to a lack of checking the claim before it is sent. At Innoval, we validate the health insurance claim before it is submitted for processing.

The benefits of medical claims scrubbing are:

  • Cleaner Claims
  • Expedite Payment
  • Reduce Denials and rework
  • Improve Cash Flow, etc.

As part of medical claims scrubbing, the following data are subject to verification:

  • Patient/Provider data
  • Insurer/Insured data
  • Medical Necessity
  • Actual procedures performed mapped to the diagnosis
  • Age and gender specific procedures
  • Data validated against Medicare, Medicaid and other standard coding rules

Denial Management

Innoval Global Solutions will handle PILES of your DENIALS! Lean on the experienced team at Innoval to painstakingly review each of your payer denials for correction and resubmittal.

Denial management consists mostly of a 3 step process:

  • Determine the exact denial reason
  • Validate denial reason. If invalid, proceed
  • Determine appeal / consideration period. If not exhausted, proceed

Claims qualifying all 3 steps, assures revenue and hence makes sense to proceed on making an appeal. Claims not qualifying either of these 3 steps should be fairly termed as a write off, unless provider wants to make a courtesy appeal.

Successfully managing denial results:

  • Image Claim resubmission
  • Image Appeals & Resolutions

Payment Posting, Reconciliation, Revenue Integrity

Trust Innoval Global Solutions with critical business activities such as payment posting and financial statement reconciliations. Years of experience have honed the highly skilled Innoval workforce to ensure payments are posted accurately and on time.

The end-to-end Innoval automated reconciliation processes thousands of daily transactions to guarantee your company recognizes each and every payment. Be rest assured in the knowledge that your statements are complete, current and accurate on a daily basis. Each transaction will be reconciled on the same day it is credited to the account and posted in the collection system. All transactions that are eligible for a refund are tracked, including the following scenarios: Unable to locate account, account recalled overpayment, or Debtor request for refund.

At month-end all data is consolidated by mode of payments, this information is reconciled with invoices to make sure all the transactions from our collection system are captured in client’s statement and vice versa. This ensures pinpoint-accuracy invoicing. Adherence to PCI standards safeguarding data means you can trust the Innoval system to protect stored cardholder information in a secure network and manage encrypted transmissions. Strict workplace policies including restricted usage of cell phones and closely monitored computer user log in and access rights ensure strong information security protocols. Each employee is HIPAA certified and is assigned a different level of password-protected security depending upon job function. Innoval’s secure payment posting process is based on the Explanation of Benefits and Electronic Remittance Advise forms. With particularly extensive experience in reviewing Out of Network claims to follow up underpayments, the team at Innoval has the knowledge, people, experience, and technology to increase efficiency and reduce cost in your revenue cycle. Innoval has a proven patient advocacy program used by providers to improve patient satisfaction by clarifying insurance coverage amounts and empowering patients to communicate effectively with payers.


Patient Pay Collections Prior to Charge Off

As part of our collections program, we work with providers to develop recovery strategies and priorities. As an extension of your company, our dedicated team of customer service and credit professionals will contact customers or patients on your behalf. Following your established procedures and our high standards of excellence, we resolve accounts, resulting in improved patient satisfaction and increased revenues. We deliver outstanding results for our clients using a combination of automated technology, sophisticated analytics and highly trained customer service and credit professionals to yield the highest return on investment.


AR Intervention Consulting

The experienced team at Innoval Global Solutions can review large pools of Live AR and suggest appropriate work strategies based on groups and segments of inventory. Innoval can analyze a cross-section of YOUR accounts to identify areas for improvement such as locating possible causes for poor payment or discovering trends and ratios pure self-pay patients compared to insurance types.


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