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Revenue Cycle

RCM & Reimbursement Software

 

The management of revenue cycle processes - including billing and reimbursements - can be time-consuming and complex for a healthcare organization. Challenges include understanding and managing all reimbursement rules, regulations, and payor-specific variables. Tracking down the required supporting clinical details from within the organization may prove difficult as well. HCS simplifies the process with our HCS Interactant Revenue Cycle module that streamlines and automates your processes with dedicated revenue cycle management and reimbursement software.

Clean Claims Mean Timely Reimbursement

Interactant Revenue Cycle handles your most challenging billing requirements. From supplemental policies to the most demanding managed care payors, Interactant's contract management and rules-based engine allows you to define payor-specific variables such as rules, regulations, edits, codes, form types, billing specifications, and reimbursement terms. Your staff enters contract variables once, works only on exceptions, and then submits claims.

Once setup, Interactant's streamlined, automated workflow:

✓ Bills activity for each payor source on the account

✓ Releases bills automatically based on organization-defined criteria

✓ Prompts users for any invalid or missing information

✓ Generates alerts for a variety of required activity throughout the billing cycle

✓Automatically adjusts revenue statistics and rebills in the case of a retroactive change by a payor

At A Glance

Interactant Revenue Cycle offers specific capabilities for healthcare organizations of all types, including: Long-Term Acute Care Hospitals (LTACH)Senior LivingBehavioral Health

Components include:

✓ Scheduling

✓ Referral Management

✓ Census Management

✓ Billing

✓Accounts Receivable

✓ Charge Management

✓ Contract Management

✓Practice Management

✓ Trust Accounting

✓ EDI

General functionality provides:

✓ Streamlined intake workflow

✓ Incoming referral tracking

✓Support for multiple 837/835 electronic specifications

✓ Direct billing of fiscal intermediaries and state funding sources

✓ Support for automatic withdrawls and ACH file creation

✓Alerts for accounts not billed, denials, and open reminders

✓ Comprehensive reporting capabilities

✓ Insurance verification

✓Patient/resident-specific contracts for self-pay and insurance carriers

✓ Automatic contractual allowance generation

✓ Medicare and non-Medicare denial tracking

✓ Compliance with all federal, state, and local regulations

✓ Automatic electronic payment and allowance posting

✓ Detailed funding information tracking for multiple third-party and private-pay sources

✓ DSM-IV and ICD diagnostic information capture

✓ Setup and maintenance support for all third-party and payor contracts (county Medicaid waivers)

✓ Total integration with Interactant EMR to ensure accuracy for RUGs, discharges, and dates of service

✓ Account Access by name, account number, medical record number, guarantor number, social security number

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