NextGenTM RCM Services Advantage

• A leading edge ACO suite of solutions — which includes RCM to help you get every dollar you deserve
• Decades of experience — working with practices to consolidate their revenue cycle process—including medical billing and collections, claims submissions and accounts receivable management
• NextGen® systems expertise — As the single largest user of NextGen® systems, NextGen RCM Services is your best source to help you benefit from all the advanced features and functionality
• A dedicated team of RCM experts — closely monitors clinical and financial data to optimize your workflow, back office functions, and bottom line

Services

• Physician Billing and Collections

  • Uses well-defined set of internal controls, checks and balances, audits, and reports
  • Addresses the entire revenue cycle: from registration and charge capture to claim submission, payment posting, and accounts receivable management

• Electronic Claims Submission

  • HIPAA-compliant insurance transactions for electronic claim submission to your payers
  • Support CMS-1500, UB-04 and ADA Dental Claim Forms; and also accommodate proprietary claim formats

• Electronic Remittance & Payment Posting

  • Minimize the need for paper storage and allow for easy viewing or printing with images of EOBs linked to the corresponding encounter at time of payment posting
  • Ensure your payments are posted accurately and promptly using our RCM experts
  • Post payments and capture specific denial information for management and tracking with electronic remittance and digital lockboxes

• Accounts Receivable Follow-Up

  • Establish joint follow-up parameters, adjustment rules, and standards for account elevation
  • Identify which claims and payers are the most valuable to your practice, and customize follow-up activities accordingly

• Customer Service: Patients

  • Knowledgeable, courteous billing professionals answer patients' billing questions reducing the drain on practice resources
  • Measurement and monitoring of key statistics such as call wait times and abandonment rates help ensure high quality service

• Account Management

  • Meet regularly with an industry expert assigned specifically to your practice to review your revenue cycle performance, the drivers behind your performance, and any trends identified

Optional Services

Clients solutions are designed specifically to meet their individual needs. Optional services include:

• Advanced Analytics
  Includes custom reporting capabilities and the ability to analyze and receive sophisticated practice revenue cycle metrics at specific frequencies

• Charge Capture
  We can enter charges for clients versus entering them through their EHR or Practice Management system

• Credentialing
  Our team and advanced technology can handle one-time or ongoing credentialing needs

• A/R Wind Down
  Assists you with collecting accounts receivable incurred prior to your relationship with us

• Software Hosting and Support
  Relieves you of associated expenses, hardware, overhead, and labor

Compliance Commitment

Our proactive Compliance Program includes a detailed code of ethics and compliance plan, continuing education, a Compliance Committee, a toll-free anonymous hotline, and compliance with all Federal, State, and local guidelines.

• Compliance Team
  Led by a vice president level Compliance Officer, the Compliance Department checks all employees and provider clients with the OIG and State annually to ensure eligibility to participate in Medicare and Medicaid programs.

• Compliance Hotline
  Members attend continuing education courses and conduct research to stay on top of current industry topics and trends.