RCM Healthcare Services for Ophthalmology

MedicsRCM for Ophthalmology: Typically Increasing Revenues by 10% - 20% and Doing Way More Than Billing and Claims!

Today you’re faced with the double-edged sword of lower insurance reimbursements and ever-growing patient responsibility amounts.

You’ll need three things:

• to maximize whatever reimbursements you get
• have a way to ensure being paid by patients on their amounts due
• MedicsRCM to help you accomplish both, and lots more!

The MedicsRCM team actually begins with revenue protection steps long before claims are submitted and patient statements are generated:

• As part of scheduling the appointment using our MedicsRCM scheduler, get an out-of-network alert if it applies to the selected ophthalmologist at all, or for the anticipated procedures to be performed. Avoid that troublesome problem from the outset.
• Also while scheduling, use the MedicsRCM patient responsibility estimator to advise as to approximately what he or she will owe after their insurance(s) has paid. It’s not too soon for that information, and to even discuss payment options.
  • The scheduler will also display the person’s co-payment amount. You’re able to remind the patient helping to ensure that’s captured on arrival.
• Note: Our MedicsPortal can be used by patients 24 x 7 x 365 to schedule appointments, make payments online and more.
• Now, the MedicsRCM team batch-verifies eligibility 3-4 business days in advance of the appointment to ensure coverage in in effect and alerts you about any issues and the reasons for them. You’re able to contact those patients and see about getting them resolved. You can process verifications for appointments scheduled for less than three days in advance including for same day and walk-in appointments.
• The scheduler’s interactive Medics Reminder Texts is an option for dramatically reducing no-shows. Patients simply reply to confirm or cancel with each response type automatically inserted into the corresponding appointment on the scheduler.
  • You’re able to quickly reschedule cancelations and see about filling in gaps with future appointments. You can also contact patients who haven’t replied at all as to their status.
  • Texts can be in multiple languages, contact maps / directions to the appointment location, and any special instructions for that particular appointment.
  • As another option, the MedicsRCM team can use texting as balance due reminders. 
• As the patient leaves their balance can be more accurately displayed and a payment, even if a partial one, can be asked for. (Reminder they could have already been made aware when scheduling the appointment.)
  • The MedicsRCM system handles and manages payment plans and multiple methods of payment including through the MedicsPortal.
  • This all works to help keep your patient receivables under control at a time when responsibility amounts are growing.
• MedicsRCM submits claims by no later than the next business day.
• But first, claims are intensively scrutinized and filtered to ensure:
  • They’re submitted at their highest possible value without over-coding which helps contribute to our clients typically increasing revenue by 10 – 20%. You’re alerted as to how to better code those claims.
  • They’re clean and correct which is why we maintain a nearly 99% success rateon first attempt clearinghouse claims
  • Our rules engine proactively alerts on claims likely to be denied based on that payer’s history. Those are able to be recoded first avoiding likely denials.
• Any out of networkclaims are submitted as are claims for workers compensation and no-fault if needed.
• The MedicsRCM team tracks your claims in real time to ensure they’re being processed by payers.
• The team instantaneously reconciles your EOBs through electronic remittance advices helping to ensure your open insurance receivables are accurate up to the minute.
• As accounts are reconciled, claims are automatically submitted to any ensuing payers until the balance is the patient’s responsibility.
• Denials are edited by the MedicsRCM team and resubmitted within 3 business days of being denied.
• The team handles appeals and works to get them resolved.
• Patient statements are generated immediately as balances become their responsibility.
• Patients can be directed to pay through the MedicsPortal using their iPad, iPhone or Android
  • Reminder that Medics Texting can be used for balance due reminders
• Patients call MedicsRCM - not you - if they have statement questions
• Clients have access to the MedicsRCM scheduler and can use it fully for ophthalmology-specific appointment types and workflow features for eliminating bottlenecks and generating appointment-related reports
• Comprehensive management and financial reports, analytics and key performance indicators (KPIs) are generated by the MedicsRCM team and regularly reviewed with clients
  • Clients can also create their own reports at any time; they can be named, saved, and scheduled to compile at user-defined times.
• For purchasable products such as frames and lenses, use the MedicsRCM system at no extra cost for:
  • Tax calculationsby product / state 
  • Inventory management
  • Clear, single view display of medical proceduresand purchased products
  • Quick checkout window for payments on purchased products
  • Gift cards and coupons are supported through the MedicsRCM system
• Use the system’s MedicsCRM at no extra cost to track any marketing or advertising campaigns
• We use our own Medics systems (the same system used by tens of thousands of providers and system operators) nationally. So, you’ll never have to worry about us waiting for support from another vendor because we are the vendor!
• MedicsRCM is cloud based and accessible by clients 24 x 7 x 365. You’re never disconnected from seeing all of your data at any time.
• Clients are trained on using the MedicsRCM system so they can use it fully, or to the extent they want.
• See how your claims are doing, your revenue and A / R, productivity and really…everything related to you!
• A single or an unlimited number of tax IDs are supported based on your needs. Reports can be generated by tax ID(s).
• The audit trail monitors system use by user. Administrators can use it to review activity by user login.
• Virtually any EHR can be interfaced with MedicsRCM, or use our e-superbill if don’t have an EHR.

We’re happy to perform a no-cost assessment as to how much we can increase your revenue and productivity. Simply complete the form on this page or call us at 800-899-4237, Ext. 2264 or by emailing info@adsc.com

"We’ve been an ADS client since 1999.

In 2017, we reviewed MedicsRCM and the MedicsPremier system. The MedicsRCM team provided us an assessment with revenue projections that were extraordinary, especially since we were already doing so well with ADS’ MedicsElite system on our server, and the Medics II system before that. But we couldn’t “un-hear” what the RCM team told us.

Based on that, we transitioned to MedicsRCM and have been incredibly happy with their predicted results!

So, we can speak positively about having had ADS systems on our server, and now with MedicsRCM and the MedicsPremier system, both of which are cloud-based."

Miyuki Frank
Lawrence Frank Ophthalmology, Rockville MD