Revenue Cycle Management
Revenue Cycle Management
Medical practices and health systems strive to provide the best possible outcomes among their patients. But at the heart of what allows them to provide the best quality care are the strong financial outcomes resulting from a well-managed revenue cycle. edgeMED's Essential medical billing and collection service handles the complete revenue cycle to ensure your organization is running at maximum efficiency and profitability - all without any management headaches all too commonly associated with medical billing.
Operating from our office locations in Florida, Wisconsin, California and New York, our expert U.S.-based team tracks, measures and collects more of the money you’re owed in less time than you thought possible, so you can concentrate on patient care, not paperwork.
Our billing and collections approach addresses the entire revenue cycle, from functions that the practice performs, such as registration and charge capture, to those that we complete, such as: claim submission, payment posting and accounts receivable management.
Our U.S.-based professionals leave no stone unturned with backend systems and payers. Keeping you in constant control of every aspect of your practice’s revenue cycle is paramount. That's why with edgeMED Essential, we take it a step further and help your practice dig deeper to analyze cost and profitability, monitor contract under and over payments and investigate new revenue opportunities, resulting in mutual success and long-lasting partnerships.
Patient No-Show Reduction
Days in A/R Reduced
Increase in Patient Visits
Using our proven methodologies, we have been exceeding physicians' expectations since 1981.
We get it right from the start. In order to assist our clients in pro-actively managing the physician credentialing life cycle, edgeMED offers comprehensive physician credentialing, re-credentialing, expirables management and delegated credentialing services to physicians through South Florida. edgeMED's credentialing specialists are comprised of industry experts who have experience across hospital, physician and vendor organizations. Our credentialing specialists have deep experience in all aspects related to managing the physician credentialing life cycle enabling your staff to concentrate on your practice and your patients.
Efficiently commence the process and improve patient balance collection using our integrated appointment scheduling component of the edgeMED Essential RCM system.
With our entire cloud-based practice management (PM) solution provided to your practice at no cost, you can easily be alerted of any outstanding patient balances, as well as verify eligibility, at the time of scheduling so staff members can provide the patient with a friendly reminder of amounts due at the time of service.
Using edgeMED’s system, your charge slip automatically populates patient and insurance information directly from the appointment scheduler, making it simple for you to mark the services and diagnosis codes provided. We populate all charges to ensure high-level accuracy that results in a 97.5% first pass payment rate and reduction in denials using our sophisticated claims engine.
Our team of experienced coders keeps your practice’s revenue cycle moving smoothly. Effective healthcare revenue cycle management starts with compliant, accurate and optimized medical coding services. As coding rules and compliance regulations continue to change, we keep you in compliance so that you can optimize reimbursement.
edgeMED’s medical billing and reimbursement experts compile and analyze the data provided by your practice, enter the information into the system, and generate HIPAA compliant claims transactions in both CMS-1500 and UB-04 formats. Our specialists not only review and balance the data, but it is also “scrubbed” for any possible errors using our advanced technology. This process ensures that claims are clean and will significantly increase first-pass payments and reduce claim denials.
Payments can be received via electronic deposit, at the practice location or through a bank lock box. Once received, payments are reviewed, posted, automatically compared against fee schedules and then balanced. edgeMED’s dedicated RCM reimbursement specialists post, analyze, research, correct, and reprocess or appeal any denials. This is performed at the time of payment posting to help ensure correct reimbursement.
Billing is never as simple as just sending out a claim. Even when a claim is paid, patients may frequently carry a second insurance, necessitating the balance from the primary claim to be sent to a secondary payer. Even on a flawless claim, it can take multiple claims or patient bills to get you paid correctly. edgeMED Essential efficiently manages this entire process for you without disruption.
edgeMED Essential performs all patient billing and follow-up activities for your practice. We realize and appreciate that your patients are to you what our clients are to us - and we treat them with courtesy and respect.
Patients are mailed a series of easy-to-understand statements. Should the patient fail to respond, a letter or call sequence is initiated to attain payment. To make it simple and convenient for patients to remit payment, we have integrated credit and debit card processing. Whether the patient remits payment at the time of service, submits payment to edgeMED via phone or visits our online patient payment portal, we provide the ease and the tools to get you paid faster and increase patient collections.
Attention! Attention! edgeMED Essential focuses on the details to ensure every patient seen has been billed, each procedure accounted for, every dollar balanced and every outstanding claim gets immediate follow-up attention. Throughout the entire revenue cycle process, edgeMED Essential integrates a series of proven internal and external checks and balances. For example, our Charge Capture Exception utility analyzes and compares the patients scheduled in the appointment scheduler (and not designated as a no-show or cancelled appointment) against claims generated for that day.
It’s no secret that payers have more and more rigorous rules, systems and loopholes aimed at not paying providers. Even though a practice may submit a perfectly clean claim to an insurance payer, there is never a guarantee that it will get paid, or that it will even be acknowledged with a denial.
edgeMED Essential uses our proprietary technology that aggressively hunts and detects unpaid and underpaid claims. Designed on a rules-based, insurance-specific engine, we can determine when a claim should be brought to the attention of one of our expert reimbursement specialists for active follow-up procedures. Most practices lose significant amounts of money through the cracks without even realizing it.
Our proactive protocols eliminate this possibility and will increase your bottom line - we’ve been doing it for nearly 40 years and you, like hundreds of other physicians located in the South Florida tri-county area, can enjoy the peace of mind you deserve.
We pride ourselves on our accounts receivable management methodology. To edgeMED, this is the most critical aspect of our Essential medical billing and collection service. We work with you to establish joint follow-up parameters, adjustment rules, and standards for account elevation. We understand which claims and payers are the most valuable to your practice and we customize our follow-up activities accordingly, using an entire team of collections specialists.
Our Essential revenue cycle management service offers custom reporting and business intelligence capabilities and the ability to analyze and package, at specific frequencies, the sophisticated revenue cycle metrics that small and large health care organizations require. With edgeMED Essential reporting, you have real-time metrics at your fingertips to make informed decisions for your organization.
We assign an industry expert, based in our Boca Raton office location, to your practice who meets regularly with you and your staff. They ensure that you understand your practice's revenue cycle performance, the drivers behind your performance, and any trends we may see. We place your entire revenue cycle under a microscope and analyze every process to ensure your ongoing success.
Connect with an edgeMED expert to discuss how to increase your revenue while simplifying your practice operations using our Essential revenue cycle services.
When it comes to billing, money matters. Improving operating processes and getting money into your hands quickly and accurately is what our Essential revenue cycle management service is all about. Some of our performance figures include…
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In addition to the expertise of our people, we embed sophisticated claims editing technology into our claims submission and management processes. Our unique claims editing technology helps us maximize your revenue potential by reducing denials, decreasing rejections, and accelerating the accounts receivable cycle.
With edgeMED as your trusted partner, you can rest easy knowing we will support you with the expert services and technology your organization needs to grow.
With an established marketplace presence dating back nearly 40 years, edgeMED continues to lead the way in revenue cycle management by offering smarter solutions that help providers compete in an evolving healthcare system.
edgeMED’s advanced clinical editing technology is a powerful, proven system that enables us to review claims before submission to payers in order to reduce claim denial rates, shorten accounts receivable cycles, and increase the rate of collection. While our competitors measure first-pass rates, we measure first-pass payment rates. We achieve first-pass payment rates as high as 97.5%. Getting money into your hands quickly and accurately is what our Essential revenue cycle management service is all about.
edgeMED's Essential revenue cycle management service will:
Increase your margins.
Find new revenue by identifying missed billing opportunities.
Accelerate your payments.
Reduce your operating expenses.
The front-end and review capability of our advanced editing technology enables us to pre-screen your claims for billing and coding errors to avoid the delays associated with incorrect coding as well as to identify missed revenue opportunities through positive edits. Our system is powered by an extensive knowledge base with more than 80 million coding relationships, including both Medicare and commercial coding, which increases accuracy and helps you receive appropriate and timely reimbursement. Plus, it helps reduce the risk of noncompliance with federal guidelines with automatic alerts that provide effective ongoing education for our staff and yours.
With edgeMED's advanced clinical editing technology, we can:
Provide superior clinical editing features, integrated into our existing claims management workflow
Streamline claims editing with the power of our extensive knowledge base of more than 80 million coding relationships, including both Medicare and commercial coding
Reduce days in A/R by checking for errors up-front and pre-screening claims - we can submit cleaner claims the first time and speed payment
Decrease rejections and denials by catching rework at the least costly point - before it leaves our doors
With payer technology and healthcare regulations rapidly advancing and becoming more complex, many medical organizations are unable to keep pace. Whether you are a physician practice, Accountable Care Organization (ACO) or medical home, we are your revenue cycle management experts so you don't have to be. We'll get you paid faster and increase your bottom line - so you can stress less and make more.
The easiest way to ensure any job gets done right is to hire a trusted expert. At edgeMED, we utilize our nearly 40 years of expertise in medical billing and consulting to achieve maximum revenue for your South Florida practice, while allotting you the time you deserve to deliver world-class patient care.
We thrive on delivering on our promises to our customers. "We do what we say we are going to do" - it's a motto ingrained in our edgeMED culture so that you can enjoy peace-of-mind knowing that we will do right by you and perform to the levels you deserve.
Since 1981, we have had the privilege of helping thousands of physicians achieve their financial freedom through our proven formula of expert US-based staff, intelligent software and unmatched customer service. Using edgeMED's Essential Revenue Cycle Management service, you can rest assured knowing you have found the company and solution you can use for the rest of your career.
Headquartered in Boca Raton, Florida, our team is U.S-based. and services our practice partners from our Florida, Wisconsin, California and New York office locations. With edgeMED, you can enjoy peace-of-mind knowing that we’re in your corner. edgeMED is a well-established company with a strong, nationwide network of medical professionals in health systems, hospitals, clinics, surgery centers and physician practices, giving us the added advantage of understanding the various reimbursement nuances between states and payers.
As insurance company profits increase at the expense of provider reimbursements, this poses a continual risk to all physicians. Taking on insurance companies can be a challenging task for most physician-based billing personnel.
In order to achieve success, you need a team of US-based, dedicated professionals who understands the nuances of billing and collections and won’t rest until you receive the money you are rightfully owed. This is a key differentiator from edgeMED and most other billing companies; many can submit a claim, but we always go the extra mile to take on the insurance companies and fight for your money.
edgeMED’s medical billing and reimbursement experts compile and analyze the data provided by your practice, enter the information into the system, and generate HIPAA compliant claims transactions in both CMS-1500 and UB-04 formats. Our South Florida specialists not only review and balance the data, but it is also “scrubbed” for any possible errors using our advanced technology. This process ensures that claims are clean and will significantly increase first-pass payments and reduce claim denials.
While edgeMED Essential performs many ancillary services to help streamline your office operations, our greatest asset is the direct impact our billing and collections have on increasing your company profitability. We not only provide you with extensive monthly reporting and full access to our billing software, but also assign a dedicated account representative to review the health of your practice on a monthly basis and make recommendations to further enhance your practice revenue.
We have been around this long for a reason; our proven billing model generates clean claims, increased reimbursement rates with fewer days in A/R, diminished denials, and reduced administrative burdens on you and your staff.
Time is money - one of the oldest sayings still rings true to this day. edgeMED Essential allows you more time to focus on seeing patients and relieves the headaches associated with managing and maintaining an internal billing staff. With your newfound peace of mind, you will no longer have to worry about your cash flow being interrupted when your biller is out on vacation, calls in sick or relinquishes her position. There will be no more wasted time and resources requried to find and train a replacement biller when the inevitable turnover occurs. Next to patient care, the most important aspect of your practice is billing. Let the experts at edgeMED show you what we can do for you. Our headquarters is in Boca Raton and easily accessible from the tri-county area of South Florida.
The foundation of edgeMED’s reputation is built on our ability to deliver top-level customer support and implementation. We understand the challenges involved in outsourcing your billing and apply our extensive experience to ensure your transition is seamless and pain free. We take a great deal of pride in exceeding the expectations of our valued clients, whether you are a small start up practice or established group of any size. Our user-friendly software combined with our dedicated South Florida support teams guarantees a quicker and easier transition, resulting in an uninterrupted cash flow.
edgeMED’s advanced and intuitive cloud-based Practice Management and EHR software provide a robust foundation to the operation of your practice without the costly fees associated with implementation, IT expenditures and ongoing support costs. Since our software is cloud-based, you will no longer have to worry with the constant maintenance and data backups associated with an in-house server, saving you both time and money. With ongoing software upgrades included, you can have the peace of mind knowing your system will always be up to date and on the cutting edge of technology.
edgeMED’s Essential medical billing and collections service provides a tangible ROI. In addition to reducing staff overhead, we also alleviate numerous additional expenditures, including Clearinghouse fees, monthly software maintenance and support, and the mailing of patient statements. When factoring in these cost savings combined with our proven track record of increasing reimbursements, it’s easy to see why edgeMED is the right solution for your practice.
In addition, since our reimbursement is directly tied into the revenues we are able to collect on your behalf, you are assured of a highly motivated team of experts dedicated to you - and focused on collecting the money you rightfully earned.
edgeMED Essential is designed to meet the needs of any sized practice. Our team of expert medical billers and collectors, plus our cloud-based medical billing software, provide the opportunity to dramatically grow your practice without incurring the traditional staffing, software and hardware fees that can cripple most practices. Our solution is even ideal for start up practices, as we hold your hand through implementation and setup while utilizing our credentialing services to get you up and running in an expedited time frame.
One of the common misconceptions about outsourcing your billing is the ensuing lack of control over your financial health. edgeMED continues to educate the healthcare community to illustrate how the right medical billing and collections vendor can expand your financial freedom, insight and control.
We provide you with complete access to our HIPAA compliant software, including up-to-date reporting that can deliver a picture of your practice’s financial health at a glance. In case that wasn’t enough, you have unlimited phone support from our knowledgeable and attentive support staff, as well as your dedicated Essential account manager to help you interpret the wealth of data at your fingertips.
If you are interested in learning more about the following specialties we service, please get in touch:
Anesthesiology billing services
ASC - Surgery billing services
Cardiology billing services
Dermatology billing services
Family Practice billing services
Gastroenterology billing services
Internal Medicine billing services
Mental Health billing services
Nephrology billing services
OB/GYN billing services
Occupational Therapy billing services
Oncology billing services
Ophthalmology billing services
Orthopedic billing services
Pain Management billing services
Pediatric billing services
Podiatry billing services
Physical Therapy billing services
Pulmonology billing services
Radiology billing services
Rheumatology billing services
Sleep Medicine billing services
Speech Pathology billing services
Surgery billing services
Urology billing services
Wound Care billing services
Connect with an edgeMED expert to discuss how to increase your revenue while simplifying your practice operations using our Essential revenue cycle services.