The traditional healthcare revenue cycle process involves medical claims submitted to one or two commercial and/or government health
insurers that are reimbursed for a full contractual reimbursement. Complex claims management, however, involves many more steps.
Many claims involve multiple payers, a claims investigation, and possible legal action pertaining to the accident that prompted the medical care.
These accident and injury claims involve third party liability, motor vehicle accidents, workers’ compensation, and other cases, which can consume
much more time for healthcare organizations than traditional billing and collections. Complex cases frequently require negotiating with attorneys
or claims adjusters, meeting stringent state and federal guidelines, and submitting numerous and lengthy legal documents to a court of law. RevClaims’
highly specialized healthcare revenue cycle management (RCM) service alleviates the burden of these time-consuming and frustrating claims from hospitals
and health systems, so hospital staff can concentrate on their core RCM competencies while maximizing revenue.