RCM PROCESS

Peregrine has a proven track record of providing our clients with increased income, reduction of denied claims, improved cash flow and savings on hard costs like paper, ink, postage, storage space, etc.  In addition, with our expert staff handling your billing, you no longer have to worry about turn-over and re-training or reduced productivity due to vacations, sick days or holidays. 
 

By allowing our staff to relieve you of this time consuming task, you and your staff will have more time to focus on your patients and building your practice!


Provider Information
Using our secured server, provider documentation is forwarded to the billing representatives handling your account via superbills, transcripts, etc.
 
Insurance Verification
Patient responsibility, insurance coverage and demographic details of the patient are reviewed for accuracy.

Eligibility
Our Eligibility Specialist will confirm the following patient benefits on each date of service:
Demographic data – if the information on the insurance identity card is up to date and correct for that date of service
Coverage – whether the patient has valid coverage on the date of service
Benefit options – patient responsibility for copays and coinsurance
Prior authorization requirements – confirming authorization for treatment from appropriate sources, if applicable


Coding Review 
If necessary, our certified coders will enter appropriate procedure and diagnosis codes with modifier placement based on your documentation

 
Entry of Charges
Each patient is entered under a separate account.  Appropriate charges for each code are assigned
 
Claims Scrubbing
All claims are reviewed for accuracy of key components before they are submitted to the payor.
 
Transmitting Claims
Following HIPAA Guidelines for transmitting claims, we will electronically transmit completed claims to the payor.
 
Follow-up/Secondary Claims
All claims are followed up on including contacting patients and coordinating with payors.  If necessary a secondary claim will be submitted.
 
 

RCM Process
Revenue Cycle Management Process

Specialties


Revenue Cycle Management FAQ
Learn more about RCM and how Peregrine's streamline process can save you time and money.

Software Expertise
Peregrine's experts can help you evaluate and select the right software for your practice.