Anyone remotely involved with the healthcare revenue cycle knows that “payers” are not really in the business of paying claims. In fact, at revMD, we refer to them as “deniers.” They load up their software with various edits in a strategic effort to “pend” a claim for additional information or they simply ignore it. When an insurance company does not pay a claim, nothing happens to them. What happens at your practice/business when you don’t pay a bill?
The “deniers” establish payment amount, payment terms and face very little consequences when they don’t pay claims they are liable for paying. It’s a system tilted towards the “deniers,” not the providers.
At revMD, we level the playing field for our clients. After 30+ years in the physician RCM business, we have stopped fighting “city hall.” Rather than attempting to change the behavior of the “deniers,” we have developed and deployed technology (Intellectual Property) that we utilize to bar code each claim and follow the claims through out the entire revenue cycle to ensure our clients get paid. When a claim is overdue or ignored, our technology identifies it and routes it to human resource (A/R specialist) skilled in the area of dealing with the “deniers.”
It is this commitment to following up on claims that has sustained us in this business since 1985. It’s our technology that allows us to commit to performing the expensive and labor-intensive task of following up on overdue or ignored claims. At revMD.com, accounts receivable follow up is not a sales oriented promise or simply a good idea, it’s a contractual obligation. If your current RCM solution does not come with a contractual obligation to research the claims you know the “deniers” are not paying, then maybe it’s time for another solution.