From patient access to payment posting, ZenMed’s structured RCM workflow ensures fewer denials, faster reimbursements, and stronger financial performance—helping healthcare providers maximize revenue and minimize operational inefficiencies.
Streamlined RCM Process for Faster Claims and Better Financial Outcomes
01. Patient Access & Registration
- Collect accurate demographic and insurance details.
- Real-time insurance eligibility verification.
- Pre-authorization for high-cost procedures.
02. Medical Coding & Documentation
- AAPC / AHIMA-certified coders for accuracy.
- Specialty-specific CPT, ICD-10, and HCPCS coding.
- Clinical documentation improvement (CDI) support to ensure compliance.
03. Charge Entry & Claim Creation
- Manual and automated charge capture for all services.
- Claim bundling according to payer rules.
- Custom scrubber to identify coding and format errors before submission.
04. Claim Submission
- Direct submission to payers via clearinghouse.
- Tracking and confirmation of claim acceptance.
05. Payment Posting & Reconciliation
- EOB and ERA posting into your EHR/PM system.
- Payment variance analysis to ensure accurate accounting.
06. Denial Management & AR Follow-Up
- Root cause analysis for each denial to prevent repeat errors.
- Denial Shield Automation for trend detection.
- Dedicated AR calling team available across US & Indian time zones.
07. Reporting & Performance Analytics
- BLISS Revenue Analytics dashboards for real-time insights.
- KPI tracking: Days in AR, Claim Rejection Rate, Collection Percentage.
- Monthly performance review meetings to optimize revenue cycle efficiency.
