How we approach the RCM process

INSURANCE CREDENTIALING & PROVIDER ENROLLMENT
Aptus will manage your payer insurance credentialing & provider enrollment needs, from initial applications to renewals.
CHARGE ENTRY
CLAIM SUBMISSION
This in turn, reduces rejections from the payer; speeding up the adjudication of the claim and receipt of payment.
PAYMENT POSTING
ERAs are automatically posted to the patient’s account through our Practice Management software. Auditing steps are in place to review for correct payment, adjustment, and resulting patient balance if any.
PATIENT STATEMENTS/PATIENT INQUIRIES
Aptus offers multiple payment options, including on-line, mail in, or call in. Patient payments are processed daily to ensure proper credit is received. Aptus also addresses outstanding patient due accounts and works closely with a collection agency of your choice.
ACCOUNTS FOLLOW UP AND APPEALS
This includes calling insurance companies, mailing in appeals, and contacting other departments for specific issues to be addressed if needed. Incorrect payment by an insurance company is determined by reviewing fee schedules and contract agreements. Action is then taken to ensure that proper reimbursement is obtained.
DENIAL MANAGEMENT
The Aptus team will identify any trends that may be occurring, and communicate this to the appropriate department so that it can be addressed and adjustments made in a timely manner to procure lower denial rates and higher, quicker returns on payments.
REPORTING
Management reports are provided showing trended graphics of your Practice’s progress. Monthly calls/meetings are scheduled with our clients to review and discuss the status of your Practice’s accounts receivable.
PERFORMANCE IMPROVEMENT
Aptus has implemented performance improvement activities in all of our processes and reporting activities. We also share front-end improvement suggestions with our clients.