RCM
Efficient Cash Flow by Delivery Certainty
RCM
Efficient cash flow offers provider organizations greater financial flexibility for managing routine operations as well as longer-term industry challenges.
CST with process improvement, operational efficiency enables client advance business-critical cross-organizational cost reduction and business effectiveness ini¬tiatives. CST helps in re-engineering RCM processes that consume valuable time and resources, provider organizations can gain the financial agility needed to excel in these challenging times.
RCM Services
With a highly specialized team of financial and clinical experts, CST offers a host of value added services from Patient Access/Management to Revenue Realization in the RCM space.
CST provides a comprehensive solution and services across Revenue Management Cycle
& Billing
Scheduling & Registration
Eligibility & Benefit Verification
Data Entry
Cash Posting
Credit Balance Report
Facility Coding
Professional Coding
Coding Audits
Coding Denials
Concurrent Coding
Provider Enrollment / Credentialing
Eligibility and Benefits Verification & Charge Capture
Electronic and Paper Claims Submission
Edits / Rejections
Payment Posting
Refunds & Credit Balance
Denial Manaagement
Correspondence & Appeal
Insurance & Self pay Follow ups
Business Analytics
Reconciliation Process
Interface experts can serve as an extension of your interface team
Project scoping, planning, implementation and delivery
Interface Monitoring and Support: 24 X 7 L1 monitoring and L2/L3 support
Coding Services
CST’s Coding Services provide temporary, long term and complete Coding Department outsourcing solutions for all account types and reimbursement methodologies with Remote Coding Flexibility.
Our expertly trained credentialed coders have vast experience with inpatient, outpatient, clinic, and professional fee coding. We adhere to strict coding compliance and quality standards that result in high-quality, accurate code assignment.
Our physician coding services address the specific needs of the provider community, including physician offices, group practices, multi-specialty clinics and specialty centers. Our certified physician coders are highly skilled and trained in CPT, E/M, HCPCS-II, ICD-9-CM, ICD-10 Coding Services and ICD-10-CM coding practices.
Services
- Improve Clinical Documentations: Data quality, completeness and authentication.
- Process Improvement & Denial Management
- Comprehensive E & M review to include ICD-9 or ICD-10 diagnoses and CPT Codes and/or HCPCS Level II Provider documentation review for severity of illness and specificity
- Map & Translate Codes
- Dual Coding Services
- Coding Audits
- Clear Coding Backlogs
- Train and test internal coders
- Train and support physicians
Key Differentiators
- Highly skilled and trained coders in CPT, E/M, HCPCS-II, ICD-9-CM and ICD-10-CM coding practices.
- Review standards are benchmarked against Federal guidelines and criteria from the Centers for Medicare & Medicaid
- Stringent Audit mechanism to ensure 95%+ accuracy
- In-house robust training program to ensure quality and adherence to client service SLA’s
- CST coding team is available 24/7 by phone, fax & Email
Clients can leverage CST credentialed Nurse Practitioners and coding resources in Undertaking Coding & Audits for Hospitals, DRG & DRG short stay audits & APC validation. Our medical coders are experienced in supporting a variety of environments, from acute care facilities to physicians services and insurance companies. Our facility audit solutions provide an objective, well-documented, third-party coding audit for inpatient, inpatient coding services, outpatient and professional service lines
Services
- DRG & DRG Short Stay Review: Based on deep clinical and industry expertise, our DRG services provide a comprehensive review and recoding of medical charts based upon the procedures and diagnoses billed by the provider to ensure the appropriate DRG is reimbursed by the payer
- Hospital Bill / Chart Audits: Our robust facility claims review ensures that our clients have up-to-date coding audit results to meet the compliance requirement.
- Compliance Review: We offer comprehensive APC, DRG and documentation compliance reviews focused on helping healthcare organizations minimize financial risk, and manage the revenue cycle.
Key Differentiators
- CST has proven expertise across diverse chart types including Inpatient, Emergency departments, outpatient diagnostics, clinics, interventional radiology and observations
- Our per chart pricing model provides more cost transparency and predictability vs. a per hour model which other vendors promote
- Our auditors are Nurse Practitioners with over 5 years of experience in analysis of ICD-9, CPT and HCPCs codes.,
- We provide detailed results, including preliminary and final reports describing coding accuracy rates, reimbursement impact, documentation quality, trends, outcome recommendations.
CST leads the way into the transition to ICD-10 coding services with a comprehensive readiness plan and transition steps. CST has AHIMA-Approved ICD-10-CM/PCS Trainers and training materials updated as per the latest CMS guidance. We have more than 500 experienced coders who are ICD-10 proficient. ICD-10 coding services is the latest in the field with comprehensive ready plan done by AHIMA Certified Coders, AAPC Certified Coders at CST in Chennai.
Services
- ICD -10 Documentation Audit: CST ICD-10 auditing, education and CDI expert staff will engage in an analysis of the current documentation gaps related to ICD-10 sufficiency or deficiency for specialty records
- Dual Coding Services:Two coders coding the same visit, one in ICD-9 and one in ICD-10, to help reduce the risk of financial uncertainty and identify focus areas for education.
- Coding Audits: Full service retrospective coding and validation audits ranging from detailed compliance, to all code ICD-10, or just risk adjustment code audits for targeted providers to assure adequate documentation
Key Differentiators
- Pool of fully trained ICD-9 and ICD-10 coders to assist the client offices to keep productivity flowing and to address claim edit/denial bottlenecks post-transition.
- A dedicated ICD-10 project manager to oversee the transition
- Stringent Audit mechanism to ensure 95%+ accuracy
- In-house robust training program to ensure quality and adherence to client service SLA’s
CST Value Proposition
Less claim denial - Accuracy and efficiency thru better training
Higher Cash Flows - Faster turn around time in terms of billing and payments by eliminating errors, denials and delays
Automation of certain manual process and procedures
Reconciliation - Daily/ Weekly reconciliation
Custom workflow tools for better, smarter and faster delivery
Smart learning tools that increase learning speed by over 40%
Proprietary document management tool for client P&Ps with stringent controls
Analytical Insights - Real time reports, forecasts in terms of surge in demand at various seasons, thereby enabling the client to make informed decisions
Professional and Highly experienced Management Team
Professionally Qualified Workforce in Life Sciences, Management, Finance & CPA
Strategic Projects - Clients can deploy their internal RCM resources in to more strategic work
Increased Savings - Free up the client in house valuable RCM resources there by reducing the capital investments in terms of IT and less operating expenses
Scalable resource pool with deep revenue cycle expertise