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Healthcare Revenue Cycle Management (RCM) is the process of managing the financial aspects of a healthcare organization's operations, from patient registration to claim submission and reimbursement. It encompasses the entire lifecycle of a patient's account, ensuring accurate and timely payment for services rendered. If you work with a trusted medical billing company in USA, it will offer the following key components:

What Is Healthcare Revenue Cycle Management (RCM)?

Patient registration and scheduling: Gathering patient information, verifying insurance eligibility, and scheduling appointments.

Insurance verification: Verifying patient insurance coverage, determining benefits, and ensuring pre-authorization requirements are met.

Coding and billing: Assigning appropriate medical codes to services provided, creating accurate claims, and submitting them to insurance companies.

Claims management: Tracking claims, following up on any denials or rejections, and ensuring prompt payment from insurance companies.

Patient billing and collections: Generating patient statements, managing payment collections, and addressing any billing inquiries or disputes.

Financial reporting and analysis: Monitoring revenue trends, identifying areas for improvement, and optimizing financial performance.

6 Years in Business:

With over 6 years of industry experience, CEC has established itself as a trusted partner in healthcare outsourcing. We bring a wealth of knowledge and expertise to deliver top-notch solutions that meet your business needs.


Nationwide Reach:

Serving over 33 states in the US, CEC has a proven track record of supporting more than 700 providers and physicians. Our extensive network enables us to understand the intricacies of diverse healthcare systems, ensuring tailored solutions that drive efficiency and improve patient outcomes.


Dedicated Staff:

Our team of 300+ dedicated professionals is passionate about providing end-to-end healthcare solutions. With their deep industry knowledge and commitment to excellence, they work tirelessly to deliver exceptional service and value to our clients.


Global Presence:

CEC operates with a global mindset, maintaining offices in both India and the USA. This dual presence allows us to leverage the benefits of offshore outsourcing while ensuring seamless communication, cultural understanding, and timely support across time zones.

The quality of care may suffer as a result of lost or delayed claim payments.

Revenue cycle management makes sure that providers have the tools they need to deliver high-quality treatment and meet the standards set by private and public payers. To manage the healthcare insurance cycle, these resources include personnel, funds, rules and regulations, and electronic health record (EHR) systems. Risks associated with a shortage of resources include fewer administrative employees to manage both new and returning patients. The practice makes less money when there are fewer patients. Additionally, if administrative resources on medical billing credentialing services are stretched thin, fewer individuals will be in charge of overseeing office conditions and safety precautions, which could result in non-compliance problems. Quality care is essential to a successful practice, just as a good practice is at the core of a streamlined revenue cycle. Therefore, it is crucial for medical professionals and their administrative staff to comprehend each stage of the billing and reimbursement process.

The front end and back end of the revenue cycle management workflow are separate components. The activities taken prior to the claim submission are considered the front end of the revenue cycle. By using medical revenue cycle management software outsourcing or automating RCM processes, healthcare providers can redirect their resources and attention to delivering quality patient care, improving overall patient outcomes.

  • Better Cash Flow: RCM ensures faster payment processing, leading to improved cash flow for the practice.
  • Increased Revenue: Efficient RCM reduces claim denials and increases the chances of receiving full payment for services, resulting in higher revenue.
  • Improved Patient Experience: RCM minimizes billing errors and simplifies the payment process, creating a positive experience for patients.
  • Enhanced Compliance: RCM ensures adherence to healthcare regulations, reducing the risk of penalties and legal issues.
  • Streamlined Efficiency: Automating RCM processes saves time and resources, allowing practices to focus on delivering quality care.
  • Enhanced Data Management: Web based medical billing software improves data accuracy and organization, providing valuable insights for better decision-making.

Implementing best practices in healthcare Revenue Cycle Management (RCM) is crucial for optimizing financial performance and ensuring efficient operations. When you outsource medical billing here are some key best practices:

  • Patient Registration and Eligibility Verification: Accurate and thorough patient registration, including verification of insurance eligibility, helps prevent claim denials and ensures proper billing.
  • Proactive Claims Management: Regularly monitoring claims status, promptly addressing any denials or rejections, and following up with payers ensures timely payment and reduces revenue leakage.
  • Streamlined Billing and Collections: Utilizing technology-enabled solutions for generating clear and concise patient statements, offering various payment options, and implementing efficient collections processes enhances cash flow and reduces accounts receivable.
  • Performance Analytics and Reporting: Regularly analyzing key performance indicators, such as denial rates, days in accounts receivable, and collection rates, helps identify areas for improvement and enables data-driven decision-making.
  • Strong Patient Communication: Clear and transparent communication with patients regarding insurance coverage, financial responsibilities, and reduces billing inquiries.
  • Compliance and Regulatory Adherence: Staying up-to-date with healthcare regulations, including HIPAA and billing guidelines, helps mitigate compliance risks and avoid potential penalties.

In general, there are many situations and industries where credentials are used. The term "credentialing" in this context refers to either insurance credentialing or medical credentialing. The terms "insurance credentialing" and "medical credentialing" are interchangeable. A process of credentialing is required for doctors and other healthcare professionals who want to submit claims to insurance companies as in-network providers, including hospitals, counselling offices, chiropractors, dentists, physical therapists, occupational therapists, optometrist offices, urgent care facilities, treatment centres, social workers, etc.

A provider can send an insurance company a straight invoice once they have obtained their credentials. Additionally, "in-network" physicians would typically receive recommendations and favourable reimbursement rates from insurance panels. After the credentialing stage is finished, contracting will receive the provider's application. A "in-network" contract with the panel may now be presented to the supplier and the practice. The fee schedule and CPT codes for which the provider is authorized to bill are often included in any contract that is extended to them.

Outsourcing medical billing offers numerous benefits for healthcare providers such as  - 

  • Cost savings: Outsourcing reduces the need to hire and train in-house billers, lowering labor costs and cutting down on upkeep expenditures for infrastructure, hardware, and software.
  • Expertise and Accuracy: medical billing solutions have experts in billing procedures and keep up with the most recent coding rules.
  • Increased income: By lowering billing errors, enhancing coding accuracy, and lowering claim denials, medical billing outsourcing helps maximize income.
  • Focus on Patient Care Is Increased: By outsourcing billing chores, healthcare professionals can shift their focus to patient care, resulting in increased patient satisfaction and improved practice productivity.
  • Scalability and Flexibility: They provide scalability, growing or contracting services in accordance with business requirements, and addressing demand changes.
  • Reduced Administrative Burden: By outsourcing billing tasks, healthcare providers are freed from the administrative responsibilities involved with billing and are able to concentrate on their primary duties and business expansion.
Vision Billing Services Company in USA

Vision Billing Services Company in USA

We at CEC are specialized in managing vision billing services. Our services are focused on maximizing return on investment, increasing revenues and improving productivity for our valued clients. Eye care professionals should focus on patient care instead of managing repetitive medical billing and revenue cycle management (RCM) tasks. Your patients are the reason why you and your staff come into the office every day. It is imperative to have RCM processes in place to get paid faster, so you have more time to care for your patients and generate revenue for a healthier cash flow. When you do not have to worry about tasks like insurance verification and filing claims, you can focus on improving patient care when your patients walk through the front door, during their visit, and after they leave. That is why having streamlined RCM processes in place are essential to run a profitable optometry and ophthalmology practice, so your revenue always keeps growing.

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Dental Billing Services Company in USA

Dental Billing Services Company in USA

We at CEC, are specialized in managing Dental RCM, all back office Dental billing work. You’ll be amazed to know how seamlessly our Team can provide support in managing Insurance Eligibility Verification, AR, Fee Schedule updates and Payment Posting, to name a few of our service offerings, for your organization. Team is well versed with almost all Dental PMS and comes with over 10 years of experience from dental RCM space.

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Our Mission

We work hard every day to bring smile on our customers face.

Our Vision

To be the best service brand, from coast to coast.

Our Values

At CEC, our values are encapsulated in WOWME: Working together, staying Organized, pursuing Goals and Targets, Motivating each other, and embodying the 4E's - Energy, Engagement, Enthusiasm, and Ethical behavior.

Medical billing software is used by healthcare facilities to track patient care episodes from registration and appointment scheduling to the final payment of a balance. This process is known as revenue cycle management (RCM).
The submission of claims for services that are directly provided to people is a component of medical billing services. Additionally, follow-ups are conducted with healthcare providers, health insurance providers, and Medicaid-like programs. Medical billing is merely a sliver of an organization's true financial capacity.
RCM companies handle medical billing services while going above and beyond to establish a patient's eligibility for claims, provide services for documentation, apply coding, and oversee the claims process from beginning to end. This is a sophisticated financial management tool that streamlines procedures for your healthcare providers, vendors, facilities, and patients in particular.
The three vital responsibilities of the patient includes sharing the right information, asking the necessary relevant questions and following the instructions as suggested by the authorities.

CEC is a leading global business process outsourcing (ITeS) company. They have the right experts who can help in processing the claims timely and also understand the process.
  • CEC - Clinical Excel Computech - Dental Billing And Medical Billing Services in USA
  • Meadowlands Plaza Suite 249, East Rutherford, NJ 07073, United States