Intelligent Revenue
Cycle Management (RCM) Engine
Turn your fragmented billing process into a fully synchronized production system where all your claims get processed, validated, and optimized in one go. Our smart RCM Engine and a professional billing team combine forces to formulate a complete revenue infrastructure that takes care of everything from the initial intake to final payment
About AltuMED
AltuMED provides modernized medical billing and coding solutions that meet all your enterprise RCM needs. Billing expertise is undoubtedly what we never compromise. But that’s not all. Our state of-the-art billing tech continues to be a gamechanger. The latest release, RCMOS, is one such system you can always rely on.
RCMOS, or RCM Operating System, works exactly like it sounds. It has a four-layer architecture, which is quite analogous to an operating system. It is so meticulously developed that it can manage your whole revenue cycle workflow, automating as much as 85% of the entire process. And it is so precise in execution that it achieves an accuracy of 95 %. This helps ensure a drastic reduction in denials and a faster cash flow. On top of that, it keeps your workflows fully compliant by automatically adhering to changes and updates in regulatory guidelines and payer rules.
Meet Neurons: The Fundamental Element Powering Your RCM Intelligence
Neurons are RCMOS’s micro-intelligent agents that process your revenue cycle. Their specific tasks include friction detection, outcome prediction, and nudging teams to make corrections before submissions. Their real-time action helps prevent revenue losses.
Denial Prediction Neuron
- Flags claims with a denial likelihood of more than 85%
- Suggests corrections for errors in coding, modifiers, and payer rules
30 40% fewer denialsa
Payment Velocity Neuron
- Predicts payment timeline for every claim
- Moves claims pending for more than 15 days to the top of the priority queue
20 35% faster payments
Revenue Leakage Neuron
- Identifies undercoded services with an average missing amount $47 per claim
- Identifies and compares patterns in physician documentation and billed codes
30% revenue capture improvement
- Processes 50,000+ claims/day with 99.7% accuracy
The RCM Operating System Stack
For clinical workflows, you need an EHR. For lab operations, you go for an LIS. But what about RCM, which most providers handle manually? Well, AltuMED offers a solution for that as well in the form of RCMOS. As mentioned above, this revenue cycle operating system uses four integrated layers, which form a continuous architecture. This architecture is what makes this system capable of handling your RCM end-to-end.
Integration Ecosystem
100+ clearinghouse integrations
EMR agnostic (Epic, Cerner, eClinicalWorks, Athenahealth)
Payer API connections for real time eligibility
End to-End Services (Completely Backed By Our RCM Operating System)
Our system is all about automation with integration, where it runs every task on its turn. We have designed this system in a way that ensures consistency and accuracy, all the while improving your RCM process.
Medical Billing and Coding
We manage the complete lifecycle of each of your claims. This involves:
- Claim scrubbing
- Claim submission
- Payment posting
All of this happens with neuron-validated accuracy.
Powered by: Automated Revenue Engine
Denial Management
RCMOS deploys neurons for the intelligent triage of tasks involved in denial prevention and rectification. Also, it generates appeal letters with supporting documentation, and that too automatically
Powered by: Revenue Intelligence Platform
Credentialling and Enrollment
The system monitors provider credentialing around the clock. Again, it s neurons that track expirations and initiate re-credentialing 90 days in advance. This is to ensure you never lose revenue due to lapsed credentials.
Powered by: Revenue Intelligence Platform
Revenue Cycle Audits
RCM Operating System processes data from millions of claims to detect patterns. The revenue intelligence layer looks for hidden leakages, compliance issues, and undercoding to notify if there is an issue. The expert auditors take care of the rest.
Powered by: Revenue Intelligence Platform
Patient Collections
We don’t just send patient statements to secure payments. Our system performs smart segmentation of statements based on the payment likelihood. It then generates payment plans and puts them into the statement. This can help improve collections by up to 25%.
Powered by: Revenue Intelligence Platform
MIPS Reporting
Our system extracts quality measures automatically from medical records. Then, the Unified Revenue Hub comes into action by aggregating the data and submitting it to CMS. The result: minimum penalties and maximum bonuses.
Powered by: Revenue Intelligence Platform
The Single RCM Operating System For Your Practice
Our billing solutions combine human expertise with the latest medical RCM technology. Our billing services have helped several healthcare facilities grow their practices over the last 15 years. Now, we have introduced smart features to our packages. This blend of human and AI has helped us scale up things in the following aspects.
Tech Enabled RCM Services That Drive Real Revenue Growth
- Full-length billing management with Automated Revenue Engine
- Predictive denial management with neuron intelligence
- Real-time visibility with specialized dashboards and portals
- Transparent performance tracking
- Specialty-based neuron training to meet specific RCM goals
- Qualified RCM team working at the backend
"AltuMED with their efficient AR management have made us stress free. 70% of our non clinical burden has been taken care of now"
Dr. Pujara
Healthcare Provider
Denial Management
Our denial management operation is a proactive mechanism. It mainly helps prevent denials to avoid extra expenditures in appealing. We also have a solid strategy for post-denial management. It involves checking for root causes, which again benefits from a human-AI alliance. It’s a speedy process that helps secure payments as soon as possible.
Patient Payment
Not only do we streamline insurance reimbursements, we also help you with patient payments. In the US, most healthcare facilities have systems to secure insurance payouts but struggle with direct patient fees. At AltuMED, we have covered this aspect by automating the invoicing process and providing multiple payment gateways. These gateways simplify fee submission for patients.
Converge: Your Command Center For The RCMOS
Converge is the interface that allows you to access the RCM Operating System. It helps you see every claim, every payment, and every neuron insight, and that too in real time.
Quantifiable Results That Speak Of Our Prowess and Tech Savviness
99%
Clean Claim Ratio
Automated Revenue Engine
97%
First Pass Acceptance Rate
Denial Prediction Neurons
30%
Revenue Increase
Revenue Leakage Neurons
20-30%
Faster Payments
Smart Workflow Command
30-40%
Fewer Denials
Revenue Intelligence Platform
Why RCMOS By AltuMED
Frequently Asked Questions About RCMOS
What is an RCM Operating System?
RCMOS is a sophisticated yet unified platform to manage your revenue cycle. It works by integrating data, intelligence, workflows, and automation in order to deliver an all-encompassing practice management experience that siloed systems can’t offer.
How do neurons reduce claim denials?
RCMOS is a sophisticated yet unified platform to manage your revenue cycle. It works by integrating data, intelligence, workflows, and automation in order to deliver an all-encompassing practice management experience that siloed systems can’t offer.
What is the difference between RCMOS and traditional billing services?
RCMOS is a sophisticated yet unified platform to manage your revenue cycle. It works by integrating data, intelligence, workflows, and automation in order to deliver an all-encompassing practice management experience that siloed systems can’t offer.
Ready To Upscale Your Revenue Cycle?
AltuMED proudly serves healthcare providers across the United States.
We understand regional billing regulations and payer relationships in all 50 states.
BCBS
Aetna
Medicare
UnitedHealthcare
Cigna
Humana
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AltuMED proudly serves healthcare providers across the United States. We understand regional billing regulations and payer relationships in all 50 states.