Revenue Cycle Management

The Complete End-to-End Revenue Cycle Management Service for Medium to Large Medical Laboratories

Ensure your claims are maximized, your patient due amounts are paid, and your processes are solid with Bikham Healthcare.

Bikham Healthcare provides a comprehensive service including all aspects of Revenue Cycle Management. Essentially, we become your internal billing department, operating as part of the lab team. Bikham is tasked with meeting your billing and financial goals, communicating regularly with Sales and Operations, and enabling management to devote its finite resources to other critical areas of the business.

Our team covers the entire RCM cycle including patient registration, up-front error processing, eligibility verification, claims processing, the resolving of rejected and denied claims, payment posting, and handling of all patient and client inquiries. As part of our process, we work with your lab to pursue missing information from physicians and patients and the sales and field support team to improve the clean claims rate from your clients. We will also suggest and develop strategies to minimize bad debt and write-offs. In addition, Bikham will review CPT coding to ensure the Lab’s efforts are in compliance with all regulations and enable the lab of every opportunity to optimize reimbursement.

Benefits & Eligibility Verification

BEV is the most crucial part of any RCM cycle. We make sure your patients plan has coverage for the test you are about to run. This eliminates all eligibility related denials and increases revenue by at least 7-10%

Coding & Submission

Claims are scrutinized ensuring maximized reimbursements without over-coding which is one of the ways we typically increase clients' revenue by 10% - 20%. We maintain a nearly 100% success rate on first attempt HCFA and UB clearinghouse claims with WC (workers compensation) and NF (No Fault) available as well. We stay on top of all PAMA updates.

AR Follow Up

We all know that Insurances will deny claims. Thus AR follow up is the most critical part of any billing work flow. Accounts receivables follow up ensures timely turn around of rejections and denials. Here at Bikham, we make sure that maximum resources are allocated to the AR follow up team so that a high number of submitted claims can be timely followed up on to enable quick action and re-working of the denials.

Denial Management

We make sure your AR experiences minimal denials. Our experts have extensive experience in overturning all types of denials and rejections and we know exactly what Lab claim denials you are dealing with. Don’t worry, we have experts who not only know how to over-turn medical necessity denials but can work their way through AR, effectively solving most denials right from coding denials, TFL, Benefits maxed, COB issues,to info pending from patient, additional request for documents etc.

Appeals / Medical Necessity

Medical Necessity denials incorporate about 50% of overall denials in any Lab’s billing cycle. We coordinate with your ordering physicians, management groups, Hospitals to ensure effective and timely submission of all necessary documentation needed to overturn the medical necessity denials. We submit extensive appeals and make sure they are approved.

EOB / ERA Posting

We make sure all your ERA and EOB’s are posted daily to ensure an accurate end of day statement for your staff to review and access average growth in revenue.

Patient Statements

With patients balances among the largest of owed buckets, successfully collecting their balances after insurance and co-payments is a must. We have what’s needed to help ensure getting every dollar from every patient. We handle patient statements and take calls from patients who have statement questions, also make polite calls to remind patients of their balances using all modes of communication including emails, fax, texts etc.

Revenue Enhancement Meets

We keep our Billing workflow highly transparent with the client. We organize monthly REM sessions with the client to make sure we map out a clear road map, going over all aging and revenue reports, showing the client exactly what we have planned to up their revenues in the coming quarter.

Prior Authorizations Made Simple

For any Lab the prior authorization process is complicated. Bikham simplifies it by enabling diagnostic service providers to reduce prior authorization related workload and denials while improving cash collections with our specialized prior authorization workflow management. This includes managing the prior authorization checks, submissions, logic, and document storage, resulting in increased revenue through the reduction of preventable denials. The process is simple!

Streamline your workflow

We scrutinize your payer mix and track all the prior authorization requesting payers and codes, work with your management groups and physicians to make sure we get prior-authorization for every single claim before you run the test.

68% reduction in time spent per account

Prevent Denials

Increase your revenue by preventing prior-authorization denials. Bikham incorporates insurance specific criteria to improve your success.

12-15% increase in revenue

Faster Turn Around

We route your cases to the appropriate benefits manager for a faster turnaround time in getting the pre authorization approved. Our vast experience working with the payers prior authorization departments comes in handy in this workflow.

25% faster time to decision

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