Atlantis RCM Revenue Cycle Management

1. Payment Posting

1.1. Apply payments (insurance and patient)

1.2. Handle electronic remittance advice (ERA)

1.3. Reconcile payments and adjustments

2. Denial Management

2.1. Identify denied or underpaid claims

2.2. Analyze reasons for denials

2.3. Appeal or correct and resubmit claims

3. Patient Billing and Collections

3.1. Send patient statements

3.2. Offer payment plans or financial assistance

3.3. Follow up on unpaid balances

4. Reporting and Analytics

4.1. Monitor KPIs (e.g., Days in A/R, denial rates)

4.2. Generate financial performance reports

4.3. Identify areas for process improvement

5. Pre-Registration / Scheduling

5.1. Collect patient demographics

5.2. Insurance verification

5.3. Authorization/pre-certification (if needed)

5.4. Provide estimates of patient responsibility

6. Registration

6.1. Confirm patient information

6.2. Validate insurance eligibility

6.3. Obtain signatures (consent, privacy, financial)

6.4. Set up patient account

7. Charge Capture

7.1. Ensure proper documentation by providers

7.2. Record services rendered (via EHR or billing system)

7.3. Use CPT, ICD-10, and HCPCS codes

8. Coding

8.1. Assign accurate codes to services/procedures

8.2. Ensure coding compliance

8.3. Utilize certified medical coders

9. Claim Submission

9.1. Claim Submission

9.2. Submit to appropriate payers (electronic or paper)

9.3. Confirm acceptance/acknowledgment from payer