Healthcare Revenue Cycle Management is a complex process. Creating claims and submitting is probably the easiest part. What is important is the follow up and tracking the claims post submission. This is to ensure that the Provider gets paid for every service rendered by him.

Reconciliation of claims is a crucial step in the Revenue Cycle that should be done regularly. Tracking of submitted claims need to be done, which claims haven’t been paid, and take action to resubmit or Appeal claims that are not paid.

Vision performs a complete Claim reconciliation for your practice at the end of every month.

The following are taken into account at the time of reconciliation:

• Claims submitted
• Acknowledgement messages from the server of concerned Health Authority
• Payments and Denials from insurance companies

Generate Monthly Reconciliation Report

A reconciliation report is generated which:

• Shows the amount settled on each claims
• Rejected/partially settled claims along with Denial reasons
• Action taken / to be taken against each rejected/partially settled claims
• Unpaid claims still in process

Generate MIS Report

A MIS report is generated which shows:

• No of Claims submitted
• No of Fully Paid claims and amount
• No of Partially paid claims, settled and unpaid amount
• No of Denied Claims and their amount
• No of Claims and Amount in Process