Services - Veridical RCM

Infrastructure Analysis

All roads lead to revenue capture. We look at all functions within your practice that impact your bottom line.–scheduling, credentialing, documentation, charge master, payer contracts and billing and collections activities—to provide you with a gap analysis for improvement. There is such a thing as a “revenue sentinel event,” an unexpected occurrence involving the death or serious injury, or risk thereof, of collections. By looking at each step in your policy and procedures, we can identify those tasks that in and of themselves appear to be performed well, but once integrated into your entire process can lead to such an event.

Billing and collections process audits

We review your processes to ensure your claims are so clean you hear them squeak as they hit the clearinghouse. Our clinical documentation review, performed with your coders, helps to ensure optimal charge capture. Once claims are adjudicated, we audit to ensure they are processed according to contract. We also help navigate out of network collections processes. If an appeal is necessary, we will guide you to the most appropriate approach – provider or patient appeal.

Hospital contract support

Negotiating an outsourced service contract with facilities can be tricky. We perform contract review to make sure your services are appropriately and compliantly reimbursed. We also make sure there are no barriers to exit if you decide the facility is not a good fit for your team.

Outsourced billing and collections

We understand that there are many factors involved in coming to the decision to outsource billing and collections services. At the end of the day, it comes down to expertise, and return on investment. Sometimes it makes more sense to keep the services in house. If the stars are in alignment, and you have certified coders and dedicated, knowledgeable, passionate employees, you should hold on to them tightly and be thankful. If you don’t, you may want to look into outsourcing.

If you do look into outsourcing, look for a group that wants to understand your needs, expectations and culture. That has a staff of certified coders, compliance officers, auditors, revenue cycle specialists and professionals. An organization that provides GENUINE. EXPERT. HEALTHCARE. REVENUE services.