Revenue Cycle Management | Empowering Healthcare with Precision, Technology, and Expertise

IRIS Cloud Coding is a medical coding service designed to boost revenue for your practice by helping you collect every dollar you earn. With built-in billing expertise and innovative technology, our RCM and medical billing services save you time and money. The main challenges healthcare providers face include:

• Rising operating costs
• Financial management amidst payer uncertainty

For improved financial performance, transparent billing services, and to correct operational inefficiencies, we can help you get paid faster.

• Cut down on expenses
  Say goodbye to the challenges of recruiting and retaining skilled staff. Outsourcing your medical coding liberates your administrative team to focus on other critical tasks.
• Mitigate your risks
  Steer clear of the pitfalls of under or over-coding. Getting it right from the start means you'll avoid the headaches linked with incorrect coding, claim denials, and audits.
• Uphold Coding Accuracy
  Utilize coding audit and review services to evaluate the precision and compliance of your coding procedures. Regular audits can pinpoint areas for enhancement, ensuring coding integrity is maintained.
• Enhance your cash flow
  Streamlined coding translates to improved reimbursement rates. With fewer rejections, payments will flow in more swiftly, bolstering your cash flow.

What to Expect with IRIS’s RCM Services

Experience peace of mind with a partner who understands your revenue cycle as well as you do. Our team offers expertise across all major revenue cycle systems, ensuring:

• Improved productivity and accuracy
• Increased clean claim submissions
• Reduced demographic-related denials
• Real-time collaboration and reporting through client portals
• Status updates and detailed reporting as your client liaison

Eligibility Verification

Eligibility and benefit verification is crucial for ensuring accurate and timely information regarding insurance coverage and determining the patient's financial responsibility. Many healthcare providers overlook this process, leading to delayed payments or denials. Accurate eligibility verification helps submit clean claims, reduces rejections, increases upfront collections, and improves patient satisfaction. We verify primary and secondary coverage details, including member ID, network, coverage period, co-pay, deductible, and benefit information.

Patient Registration / Patient Demographics

Accurately capturing patient information at the point of service is essential for the success of your revenue cycle. Errors in patient demographic information can cause claim denials and delayed payments. Accurate data entry increases clean claim transmission and timely reimbursements. Studies show that medical practices can lose up to 7% of their annual revenue due to demographic data errors. We review and update patient information, including legal name, gender, address, date of birth, phone numbers, and health insurance details.

Patient Pre-Authorization

Our prior authorization team excels in:

• Determining authorization requirements
• Preparing and submitting necessary information to payers
• Following up on authorization requests
• Notifying providers of any issues

Value Proposition for Eligibility Verification and Prior Authorization Services

• Optimize cash flow
• Reduce patient-related denials
• Avoid claim rejections due to inaccurate information
• Identify patient responsibility upfront
• Improve patient satisfaction