RCM SERVICES
RCM SERVICES
DRIVING REVENUE GROWTH WITH STREAMLINED REVENUE CYCLE MANAGEMENT PROCESSES
End-to-End Revenue Cycle Management Solutions
Fusion CX offers comprehensive Revenue Cycle Management (RCM) services designed to streamline the entire billing process for healthcare providers, ensuring accuracy, efficiency, and compliance. Our solutions cover every phase of the revenue cycle—from front-office support to mid-cycle support and back-office functions—helping health plans and providers optimize cash flow, reduce claim denials, and improve financial outcomes.
With over 35 years of experience, Fusion CX combines advanced technology, industry expertise, and a commitment to customer service to manage the complexities of healthcare billing. This enables providers to focus on patient care while we handle the financial aspects of their operations.
TRANSFORMING REVENUE CYCLE MANAGEMENT THROUGH TAILORED SOLUTIONS
FRONT OFFICE SUPPORT
Fusion CX helps streamline front-office functions to ensure smooth workflows from the moment a patient seeks care:
Insurance Verification and Eligibility Checks
Accurately verify insurance details and patient eligibility before services are provided, ensuring that claims will be reimbursed.
Preauthorization and Precertification Management
Manage preauthorization and pre-certification requirements, ensuring that the patient’s insurance plan covers all procedures and treatments before they take place.
MID-CYCLE SUPPORT
Fusion CX ensures that all billing and coding processes are managed efficiently to minimize errors and optimize reimbursement:
Medical Coding, Including HCC Coding Services
Ensure accurate coding for medical procedures, including HCC coding, to maximize reimbursements and comply with regulatory standards.
Claims Submission and Edits
Submit claims to insurance providers promptly and make necessary edits to improve acceptance rates and minimize denials.
Charge Capture
Accurately capture charges for all services provided to ensure proper billing and prevent revenue leakage.
HCC Coding Services
Specialize in Hierarchical Condition Category (HCC) coding to accurately capture the complexity of patient conditions, optimize risk adjustment scores, and maximize reimbursements.
BACK OFFICE SUPPORT
Fusion CX supports your back-office operations to ensure that claims are processed, payments are reconciled, and accounts are managed effectively:
Payment Posting and Reconciliation
Accurately post payments and reconcile them with accounts to ensure that all transactions are recorded and discrepancies are quickly addressed.
Accounts Receivable Management and Collections
Manage outstanding accounts receivable to reduce days in AR, and handle collections efficiently to ensure steady cash flow for healthcare providers.
Denial Management and Appeals Processing
Manage claim denials by identifying causes, initiating appeals, and working with payers to resolve issues and ensure reimbursement.
Patient Balance Follow-Up
Proactively engage with patients to resolve outstanding balances, offer flexible payment options, and ensure a positive financial experience.
AI SOLUTIONS FOR REVENUE CYCLE MANAGEMENT
Arya (RCM Support Coach)
Provides real-time assistance to streamline claims processing, payment posting, and denial management, ensuring accuracy and faster reimbursements.
Conversational AI
Enhances patient and provider communication with AI-driven voice bots for eligibility verification, billing inquiries, and payment reminders.
Marketing AI
Drives patient and provider engagement through targeted outreach campaigns and personalized communication strategies to enhance payment compliance and revenue growth.
AI QMS
Automates audits and compliance checks to maintain billing accuracy, HIPAA compliance, and high service quality standards.
MindSpeech
Improves call clarity and professionalism with voice harmonization and real-time noise cancellation, enhancing billing and collections support.
THE FUSION CX-FACTOR
20K+
Skilled
Agents
PCI-DSS
Certified
25+
Language
Support
Ensured Business
Continuity
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WHY CHOOSE FUSION CX FOR REVENUE CYCLE MANAGEMENT?
Comprehensive RCM Solutions
Fusion CX provides full-service RCM solutions, covering every aspect of the revenue cycle, from front office support to back-office reconciliation.
Efficient Claims Management
We streamline the claims submission and payment reconciliation processes, reducing denials and improving reimbursement rates.
Scalable and Flexible Solutions
Our RCM services are scalable to meet the needs of healthcare providers of all sizes, ensuring that we can handle growing patient volumes while maintaining operational efficiency.
Expert Medical Coding and HCC Services
Our team ensures accurate medical coding, including HCC coding services, to ensure proper reimbursement and compliance with healthcare regulations.
Data-Driven Analytics
Fusion CX leverages advanced technology and data analytics to optimize RCM processes, reducing claim rejections and improving overall financial performance.
FAQS
FAQS
What services does Fusion CX offer for Revenue Cycle Management (RCM)?
Fusion CX offers front office support, medical coding, charge capture, claims submission, denial management, and payment reconciliation to streamline the entire revenue cycle.
How does Fusion CX handle insurance verification and eligibility checks?
Fusion CX verifies patient insurance and eligibility in real time, ensuring claims are processed smoothly and that the patient’s coverage is up to date.
Can Fusion CX assist with HCC coding?
Yes, we provide HCC coding services, ensuring that all medical codes are accurate and compliant with industry regulations to optimize reimbursements.
How does Fusion CX manage claim denials?
We manage denials by identifying the reasons for rejections, handling appeals, and working with payers to resolve issues and improve claim acceptance rates.
Why should healthcare providers choose Fusion CX for RCM?
Fusion CX offers a complete suite of RCM services, combining industry expertise, AI-driven solutions, and a commitment to accuracy to improve revenue cycle efficiency and maximize reimbursements.
