REVENUE MANAGEMENT SOLUTIONS
In today’s evolving landscape, home care agencies face a growing set of challenges being reimbursed quickly and correctly: increasing billing complexities, payer diversity, and operational costs to name just a few. For a growing number of non-Medicare agencies, Revenue Cycle Management outsourcing to RMS is proving to be a way to better maximize revenue and collections, accelerate cash flow, reduce cost, and allow them the time instead to focus on improving quality and growing their business.
WHAT WE DO
Simply put – we become your claims management department, improving your revenue cycle performance. We submit your claims, quickly work any rejects and denials with your Payers, post and reconcile your cash, scrupulously manage (minimize) your A/R and provide robust and timely reporting. Our highly skilled team works with local and state Managed Care, Commercial Insurance, Municipal and other Payers, as well as private-pay Clients, to maximize your reimbursement.
Contract setup & maintenance, pay/bill data management, eligibility checking, “on-hold” claims.
Pre-billing claims cleanup, claims submissions, EDI maximization; rejections remediation & mitigation, process feedback.
Electronic remittance facilitation, posting & reconciliation, backlog remediation, lockbox service.
Aging AR recovery, updates & feedback, robust suite of management reports and analytics.
“I have had the pleasure of working with the Sandata RMS group for over two years. They understand what it takes to collect aging Home Care receivables and do an outstanding job of maximizing the amount collected. The RMS group leaves no stone unturned in terms of looking for all available documentation that can support the claims in question. The staff is very knowledgeable and responsive and also provides us with analytics and operational insight that allows us to improve billing quality going forward.” –Kwabena Achampong, Director of Finance, Home Care Services For Independent Living.
“Several years ago, we had deep concerns of how we would to be able to keep up with the demands presented by managed care. We had proposals of being bought out by larger more powerful agencies because as they said, we would not be able to survive. Then to our rescue came RMS and alleviated that concern. They are extremely knowledgeable of Managed Care billing. Our billing goes out timely and accurately. Denials are not only addressed, but RMS works with us to eliminate root causes for future denial reduction. RMS has gone all the way to senior level executives at MCO’s to obtain resolution of aged receivables issues. We are extremely happy we decided to work with RMS. The decision and investment was well worth it!” –Lisette M. Smith, RN, Executive Director,Bushwick Stuyvesant Heights Home Attendants, Inc.
“We outsourced to RMS and our cash flow improved significantly in 60 days. They resolved aged receivables and current billing issues, and we are getting paid much more quickly and at a higher percentage of what we bill than we did in the past. RMS actively engages with me and my staff, and helps us through any new issues that arise.” –Jenny Chan, President, ABC Health Services Registry, Inc.
Revenue Management Solutions is a leading provider of end-to-end services to home care agencies to improve revenue, cash flow, and reduce cost. Our leadership team and staff leverage many years of experience to maximize the success of our partnerships with our agency clients.
Vice President, RMS
Vice President RMS
Executive responsibility for RMS, including account management, business development, and fiscal reporting. Phil is a CPA with over 15 years in home healthcare, in financial and operations roles.
Phil spent seven years with a large multistate Pediatric and Adult nonskilled home healthcare agency,where he held the role of Vice President of Operations, and then Vice President of Contracting and Legislative affairs, which included MCO account management in all states. In addition he spent seven years with a large national home health provider, with roles in financial operations, revenue cycle management, payer receivable workout negations, and provider relations.
Senior Director, RMS
Manages daily operations of RMS; develops processes and procedures, and coordinates onboarding of new customers. In addition, oversees programming of our proprietary RMS claims management system.
Donna was a “founding member” of RMS, which was initiated while she was also running a Sandata contract which provided billing and claims management to the NY City Department of Health and Mental Hygiene. Donna has extensive relationships with MCO Payers. Her thirty plus years of experience in healthcare reimbursement includes; home healthcare, physician practice, and hospital revenue cycle management in the Medicaid, Medicare and Commercial insurance environments.
Resident expert on EDI claims billing and payments, and the interfaces between provider systems and EDI clearinghouses. He’s our technical liaison to third party administrators. Bob leads the ongoing further development of the RMS revenue cycle management system. Bob’s responsibilities include understanding 5010 EDI payer requirements, and educating personnel on 5010 billing compliance.
Bob has over thirty years of experience in the healthcare practice management and home healthcare environments as a programmer analyst. In addition, he has extensive knowledge of electronic file processing for claims submissions, remittance processing, and eligibility processing and claim status inquiry.