Revenue Cycle Management
Our team of experts handle every aspect of the revenue cycle management, including:
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Patient registration and eligibility verification
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Obtaining authorization and verification of benefits
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Charge capture and coding
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Claims submission and follow-up
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Denial management and appeals
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Patient financial counseling and collections
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Reporting and analytics
Obtaining Authorization and Verification of Benefits
We work closely with insurance providers to obtain necessary authorizations and verify patient benefits. This includes:
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Submitting prior authorization requests
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Tracking authorization status and follow-up
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Verifying covered services, limitations and exclusions
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Communicating benefit information to patients
Eligibility Verification
We verify patient eligibility for insurance coverage to ensure timely and accurate reimbursement. Our team checks for:
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Active insurance coverage
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Deductibles and copays
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Benefit limitations and exclusions
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Pre-existing conditions
Our Salient Features
HIPAA Compliance
At Vanguard RCM, we prioritize HIPAA compliance to protect the confidentiality and integrity of PHI. Our comprehensive compliance program includes:
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HIPAA Risk Assessments to identify potential vulnerabilities
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Implementation of administrative, physical, and technical safeguards
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Regular employee training on HIPAA regulations and best practices
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Continuous monitoring and improvement of our compliance measures
Safeguading PHI Data
We employ robust data security measures to protect PHI throughout the revenue management process. This includes:
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Secure data storage and transmission using encryption
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Access controls and user authentication
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Regular data backups and disaster recovery plans
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Strict policies and procedures for handling PHI
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Ongoing monitoring and testing of our security systems