Revenue Cycle Solutions

Revenue cycle management (RCM) is more than just billing and collections. It starts with the delivery of a critical patient care service, and moves through a process of coding, charge entry, claims submission, payment posting and accounts receivable management to ensure final collections.

Given the complexity of this multi-step progression, it is no wonder that Medical Group Management Association (MGMA) data indicates 30% of initial claims are rejected, and 15% of claims are never paid due to incorrect billing._^* These are staggering statistics you can’t afford to ignore in an environment of increasing expenses and overhead, stagnant revenues and heightened regulatory scrutiny.

Practice administration consumes a considerable and increasing amount of physicians’ time. The revenue cycle management services offered by Nephrology Practice Solutions (NPS) are intended to reduce administrative burden, enhance operational efficiencies and position your enterprise for success. It’s a complete solution, including:  

• Credentialing Services: Credentialing Services assist providers being able to deliver critical patient care services and receive appropriate payment for those services. Learn more about credentialing services.
• Coding: Minimize compliance risk and billing errors by utilizing reviews and annual guideline update education performed by a Certified Professional Coder. Learn more about coding services.
• Billing and Collection: The web-based billing and collection solution helps you to collect more of what you earn. Revenue capture is maximized through electronic claims processing, and the use of a powerful and continuously updated rules database that flags medical billing errors in real-time allowing for an exceptionally accurate claim submission rate.

Not sure if you need a complete revenue cycle solution? Individualized consulting services are available when a practice’s needs require a precise focus, expertise or experience outside of what’s available in the normal practice, or when independent objectivity is called for. In fact, this is where most providers start.

A few examples of our consulting services include:

• Revenue Cycle Assessment: This assessment is designed to evaluate core administrative processes and support functions, and analyze performance gaps that could be affecting your bottom line based on key financial practice metrics.
• Coding Audits: Coding Audits evaluate the accuracy of current processes and mitigate compliance risk by evaluating whether the chart documentation reflects the depth of care provided.
• ICD-10 implementation: ICD-10 implementation will result in moving from 10,000 codes to over 150,000 codes.  NPS can help with the transition from ICD-9 codes by providing up-to-date medical coding tools and templates.
• The Centers for Medicare and Medicaid Services (CMS) has put in place Recovery Audit Center (RAC) and Comprehensive Error Rate Testing (CERT) to evaluate the quality and accuracy of claims. These audits have regulatory and financial practice implications. NPS can help you better understand what these changes mean to your enterprise.
• Cost Reduction and Overhead Analysis: Our analysis is intended to assess your practice's current situation compared to industry norms and best practices, and we can determine if the enterprise is positioned to achieve its goals. 

Get In Touch
Give your business the attention it deserves. Call Nephrology Practice Solutions at 1-866-434-9029, email PracticeSolutions@DaVita.com, or contact us.   

_{*Benchmark Your Revenue Cycle's Performance: A Five Step Guide, Chris George, www.thinkfirst.us}