RCM360
Outsourced RCM Powered by Analytics and Automation
Managing A/R, no matter the size of your healthcare organization, is one of the most complex and time-consuming tasks associated with running a healthcare facility. Overcome the fear and resource strain associated with filing claims and boost claim acceptance. Free internal staff from the tedious process of entering and formatting confidential patient information and coding.
How RCM360’s Outsourced Model Is Different
- Automated eligibility and claim validation to reduce preventable denials
- Analytics-driven work queues that prioritize follow-up by financial impact
- Ongoing denial trend analysis to reduce repeat issues
- Transparent dashboards that provide visibility into performance and progress
Revenue Cycle Management
Overcome these healthcare finance burdens:
35% of denied claims are never worked
Claims are 27% more likely to be paid if submitting within 7 days
90% of denied claims are a result of submission errors
RCM360 addresses these challenges through automated claim checks and ongoing denial analytics.
Automation in Action: Technology That Drives Results
Real Revenue Cycle and Billing Efficiency, Real ROI
RCM360 designs and deploys automation inside your EHR, reducing manual work while accelerating your revenue cycle.
Automation Highlights
- ERA Posting Review Bot – Cuts manual posting review by 50–75%, improving speed and accuracy
- Claim Status Follow-up Automation – Ensures rejections/denials are worked within 48 hours and no-response claims are followed up every 30 days
- Eligibility & Benefits Verification Bot – Summarizes payer eligibility data into specialty-specific summaries, saving front-office time and improving accuracy
Improve Every Step of the Revenue Cycle with RCM360
RCM360’s onboarding process includes a diagnostic, optimization, and acceleration program designed to enhance system performance and financial outcomes. Ensure every step of your revenue cycle is working at peak efficiency, spanning:
Front Office Optimization
- Comprehensive review of Scheduling, Registration, and Referral processes during onboarding.
- eCW/NextGen configuration and training improvements for:
- Resource scheduling
- Registration rules
- Healow/kiosk check-in
- Patient portal optimization
- Appointment reminders and insurance list cleanup
Outcome: Improved accuracy, shorter check-in times, and fewer registration-related denials
Coding & Claim Submission
- Initial chart audit: 10 E&M charts per provider during onboarding
- Annual or per-chart options
- Two-week claim review window to identify coding gaps
- 90-day progress note review for pattern analysis
- Rules and edits optimization:
- eCW: Claim Rules Engine
- NextGen: Claim Edit Library
Outcome: Higher first-pass acceptance, consistent coding accuracy, measurable revenue lift
Patient Accounts & Payments
- Patient payment workflow review and recommendations during onboarding
- Integration with PayGround for faster, frictionless patient collections
- Includes Text to Pay and IVR payments
- Optional integrations
- Digital payment plans
- Integrated collections (TSI) when needed
Outcome: Improved patient satisfaction and reduced collection costs
Charge Capture & Provider Workflow
- Onboarding discovery includes review of coding and progress note workflows.
- Activation of automation jobs:
- eCW: Scheduled jobs for locked notes > claim creation
- NextGen: BBP jobs > clean claim generation
- Provider template and clinical rule optimization recommendations
Outcome: Cleaner claims, faster charge creation, reduced lag days
Claims Follow-Up & A/R Management
- Dual-team approach
- Dedicated backlog A/R team for legacy cleanup
- Ongoing A/R team for current claims
- All rejections/denials worked within 48 hours
- Follow-up on all claims with no payer response within 30 days
- Platform optimization
- eCW: Custom eBO/Excel tools and claim work queues
- NextGen: Configured claim work queues and automated status triggers
Outcome: Faster recoveries, reduced aged A/R, improved cash predictability
Optional Value-Added Services
- Credentialing
- Contract management and fee schedule review
- G/L integration
- Smart lockbox and payment reconciliation
RCM360 doesn’t just process claims. We optimize the entire revenue cycle ecosystem, so your team operates at peak efficiency and profitability.
Get Started With A Free A/R Analysis
RCM360 has created a custom A/R analysis for your EHR application based on the many years of experience in developing new collections workflows and processes. It’s provided at no-cost and does not require a contract.
Request your free A/R analysis to get started and we will provide the following:
Opportunity Data Report
A snapshot of your account over the last two years. The Opportunity Data Report shows average charges, average payments, adjustments, claim counts, and more. It enables RCM360 to get an overall view of the current situation and make informed decisions on how to improve.
Opportunity Dashboard Report
The Dashboard Report provides details of your workflow process. It includes daily payment average, net collection rate, trending numbers, locked notes, and unlocked notes. It allows us to uncover red flags so we can provide a plan to address key issues.
Claim Activity Report
This report is custom report designed by RCM360. Within this report, we look at the payment on the claim, a denial on the claim, or a note on the claim.
Staffing Challenges
Like any business, the operation of a medical facility is highly dependent on having skilled, quality staff in place. Yet when it comes to billing, you may find challenges finding, retaining and managing these professionals. There’s a very niche area of knowledge and experience required to perform the job effectively. RCM360 has this knowledge and passion, and we’re ready to leverage it on your behalf.
Outsource your billing to RCM360 and avoid the many staffing challenges you may be facing in your healthcare organization.
You’re experiencing staff loss and high turnover.
This indicates that medical billing professionals are changing jobs now more than ever, and that poses problems for your billing and collections. You may find yourself in an endless cycle of finding qualified candidates, hiring, and training. This costs time, money, and lack of continuity for your healthcare organization.
You’re growing.
Growth is a great thing, but it can also bring some pains. You may find that your current staff is stretched too thin to get claims filed in a timely manner. And if a rejection comes in, who knows where that will rank on your staff’s to-do list.
The talent pool is small.
You’re seeking someone with a specific set of skills and talent who must have knowledge of both medical billing and coding. One minor error could result in rejection and delay of payment — or no payment at all.
You’re having trouble managing the billing staff.
A growing team requires growing management needs. Someone must oversee day-to-day operations and time management, ensure the work is covered when a team member goes on vacation, deal with performance or relationship problems, hire, train, retain, educate, etc. If there’s not someone dedicated to this, things can quickly go awry for your billing.
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