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Revenue Cycle Management

With 99% accuracy, we have managed over 700,000 cases.

ABOUT

As the largest Revenue Cycle Manager in India, we solve some of the real-life challenges faced by large hospitals

We work as an integral part of the hospital's operations, providing support from pre-authorization till claim settlement. We optimise billing and claim processing.

Having successfully handled over 7 lakh cases to date with 99% accuracy, our expertise ensures error-free and timely claim filing. This, in turn, leads to improved profit margins, reduced disallowances, and quicker claim settlements across all insurance providers, TPAs (Third Party Administrators), CGHS (Central Government Health Scheme), ECHS (Ex-Servicemen Contributory Health Scheme), Ayushman Bharat, and other credit schemes.

We specialize in delayed and denied cases. Our dedicated team of doctors helps you with query resolutions, delayed or denied claims, and represents you at arbitrations and other relevant forums whenever required. We understand the importance of securing your rightful reimbursements and work tirelessly to safeguard your interests.

By entrusting your Revenue Cycle Management to us, you can focus on delivering exceptional healthcare services, while we take care of the financial aspects with precision and expertise.

Benefits

Case Studies

Resolved Cash Flow Issues and Improved Revenue in Trivandrum's Leading 200-Bedded Hospital

A leading 200-bedded hospital of Trivandrum faced challenges related to delayed submissions, inaccurate query handling, and coding errors. The hospital was facing major cash flow issues leading to delayed salary and vendor payments. Our RCM services brought changes in billing software, Process streamlining, Billing enrichment, Internal marketing, and New scheme affiliations. A separate team of MBBS, and MD doctors worked on Disposed off claims.

Outcome

We successfully improved Cash Flows, recovered 70% of the disposed-off amount within 6-7 months, and increased revenue by 100% to 5 crores per month within a year.

Optimized claim processing and increased capacity utilization in a 600-bedded Medical College & Hospital.

A hospital near Kozhikode was operating at 35-40% capacity. They had to increase the capacity utilisation for regulatory reasons. All the doctors were on rolls, resulting in high costs & under-utilised resources. The hospital wanted to develop Cardio as a super-specialty department. GMoney’s team analysed the costs and spare capacities and empanelled the hospital with Ayushman Bharat and optimized claim processing.

Outcome

The credit Scheme Revenue of the hospital has doubled to 2 crores per month with the same resources and their regulatory requirements have been fulfilled. Their average capacity utilisation has now increased to 80%.

Maximized Revenue and Improved Patient Experience for Bangalore Hospital

A reputed trust hospital in Bangalore was operating at nearly 100% capacity but revenue was low. Average deductions in Mediclaim were in the range of 10% and the settlement cycle was around 60 days. The staff was unable to handle discharge beyond 2 p.m. Discharge delay was the major reason for patient and consultant dissatisfaction.
GMoney worked on billing and claim process optimisation and started facilitating discharge till 10 p.m. We streamlined multiple processes and introduced evening discharge in package cases to create additional capacity and save a day’s cost.

Outcome

Within 12 months, the disallowances have come down to less than 1%. The additional capacity created innovatively is mostly used by Consultants for day procedures, where admission is facilitated at 6 a.m.
The claim settlement cycle has come down from 60 days to less than 15 days. The discharge experience of the Patient/Consultant has improved significantly. The credit Scheme revenue has increased from 1.2 crores to 2 crores per month. Revenue has increased from 30 lakhs to 70 lakhs per month with the same resources.

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Revenue Cycle Management

ABOUT

As the largest Revenue Cycle Manager in India, we solve some of the real-life challenges faced by large hospitals

We work as an integral part of the hospital's operations, providing support from pre-authorization till claim settlement. We optimise billing and claim processing.

Benefits

Case Studies

Resolved Cash Flow Issues and Improved Revenue in Trivandrum's Leading 200-Bedded Hospital

Outcome

Optimized claim processing and increased capacity utilization in a 600-bedded Medical College & Hospital.

Outcome

Maximized Revenue and Improved Patient Experience for Bangalore Hospital

Outcome

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