Medical Revenue Service by INOVA MedSolutions, generates and collects payments for the services a provider provides to their patients. It’s a complete RCM solution managing end-to-end RCM operations like patient registration, insurance verification, coding, billing, and collections. Our RCM billing company optimizes revenue cycle for better financial outcomes of the physician’s medical center.
As the go-to credentialing specialists for healthcare organizations, we offer comprehensive services in medical credentialing, enrollment, and licensing. Below is a list of our most commonly requested services:
Although we work as a contract credentialing team, we seamlessly integrate with your administrative staff, helping you navigate the credentialing process and achieve successful application outcomes.
Our services include enrolling providers in Medicare and Medicaid, two of the largest health insurance programs in the US with millions of beneficiaries. By joining these programs, providers can enhance their patient base, increase revenue, and ensure compliance with federal and state regulations.
We handle the credentialing of providers with commercial insurance payers like Aetna and Humana, which offer diverse plans and networks. By working with these insurers, providers can expand their patient access and negotiate improved reimbursement rates.
We help individual providers (Type 1) and organizations (Type 2) secure and maintain their National Provider Identifier (NPI). This unique 10-digit number, provided by the Centers for Medicare & Medicaid Services (CMS), is required for all billing, reporting, and electronic transactions.
We support providers in setting themselves apart from their competitors. Our credentialing specialists manage and update each provider’s profile on the Council for Affordable Quality Healthcare (CAQH) ProView, an online database for credentialing information. By leveraging CAQH ProView, providers can streamline their credentialing process across multiple health plans.
We handle the revalidation and re-credentialing of each physician’s enrollment and credentialing status with Medicare, Medicaid, and commercial insurers. By entrusting these processes to INOVA MedSolutions, providers can maintain their program eligibility effortlessly and prevent any disruptions or penalties.
Managing the complex and often slow insurance credentialing process can be a challenge. Our expert credentialing team streamlines enrollment, helping to optimize your revenue management lifecycle.
Our specialists in credentialing and privileging investigate reimbursement problems such as underpayments, denials, delays, or errors from insurance payers. We also provide accounts receivable (AR) follow-up services to facilitate the collection of overdue payments. By tackling these reimbursement issues and handling AR, providers can boost their cash flow, decrease bad debt, and refine their revenue cycle.
| In-House Billing | INOVA MedSolutions RCM | Results | |
|---|---|---|---|
| Charges (on average) | $142,000.00 | $142,000.00 | |
| Gross Collection Rate (GCR) | $60,000 (42%) | $77,000 (54%) | 12% Increase in Gross Collection Rate |
| Billing Costs | $6,000 | $4,000 | $2,000 Decrease in monthly cost of RCM service |
