Your Partner in Revenue Cycle Management

An effective RCM strategy requires a practiced hand and a knowledgeable staff. Partner with Aptus to ensure your RCM process is managed with integrity, experience and precision.

How we approach the RCM process

INSURANCE CREDENTIALING & PROVIDER ENROLLMENT

Aptus is intimately familiar with the negative impact that improper payer enrollment and credentialing has on a Practice or facility.  Enrolling physicians can be taxing and time-consuming, especially with varying payer application procedures and guidelines.

Aptus will manage your payer insurance credentialing & provider enrollment needs, from initial applications to renewals.

INSURANCE VERIFICATION & PRECERTIFICATION

Using Aptus’ scheduling & registration solution, verify benefits electronically with the patient’s insurance carrier to review coverage details and precertification requirements.

PATIENT REGISTRATION

Let our patient scheduling & registration solution guide you through the process of registering a patient.  Or utilize your existing Electronic Health Record to register the patient and Aptus can interface with your existing solution.

PATIENT ENCOUNTER AND EHR

Use Aptus’ EHR or Aptus interfaces with multiple EHRs on the market.

 

 —Your specialty, your way—

Our EHR is customized to your practice’s and providers’ preferences.

 

If you practice documents patient encounters manually, Aptus can also accommodate your Practice.

CPT & ICD10 CODING

Documenting in an EHR provides the data needed for accurate and complete coding choices. Aptus staffs CPCs (Certified Professional Coder) that are available for coding advice.

CHARGE ENTRY

Aptus options include an automatic interface of billing data from your EHR to our Practice Management software or our charge entry staff will enter the data for your Practice. Either method includes auditing to verify that data is entered correctly and that all of your encounters have been successfully captured.

CLAIM SUBMISSION

Aptus utilizes two levels of data scrubbing prior to submitting claims for your practice. These steps are in place to catch coding and data entry errors before the claims are submitted to the payer.

This in turn, reduces rejections from the payer; speeding up the adjudication of the claim and receipt of payment.

PAYMENT POSTING

Aptus uses ERAs (electronic remittance advices) when applicable and is fully prepared for hand keying paper remittances. 

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

After ensuring proper payment from the patient’s insurance has been applied to their account, any remaining balance that is the patient’s responsibility will be communicated to them via a statement explaining the amount due. A toll-free number is provided on the statement so that the patient can contact Aptus directly to inquire about his/her account. 

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

Once payments are posted, the A/R team reviews accounts for non-payment or incorrect payment by the payer. Our highly trained A/R staff at Aptus is efficient at determining the reason for non-payment, having the claim corrected, and resubmitting for prompt payment.

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

Denial management takes Accounts Receivable Management a step further by using analytical and auditing tools to track, evaluate, and determine means to prevent future denials.

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

Two levels of reporting are provided by Aptus for your Practice.  Accounting reports are provided supporting an audit trail of all charges, payments and adjustments for the month.  Accounts receivable is “rolled” to ensure the integrity of the accounts.

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

If nothing is learned from the monitoring of processes and reports, then nothing is gained for the Practice. 

Aptus has implemented performance improvement activities in all of our processes and reporting activities. We also share front-end improvement suggestions with our clients.

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