RCM Customer Onboarding for Success – The AIMA Way

This brand-new blog looks at the commercial importance of thorough customer onboarding for physician practices and laboratories when you begin working with a new revenue cycle management partner. We consider what processes should be covered and what to look for when considering hiring a new medical billing company.

Cash is King. A mantra most businesses quickly learn to be true. For healthcare businesses, such as yours, the real problem is so many external factors dominate healthy cash flow. The management of a myriad of payers, a plethora of payment systems, endless bureaucracy, opaque regulations, and mind-numbing red tape, to name but a few. We get it; you just want to recoup your hard-earned dollars.

Every day, we hear from healthcare business owners who started out with a simple desire to help patients in their practice or through their laboratory testing. But somewhere along the way, the dreaded medical billing machine got in the way. Enter – a dedicated Revenue Cycle Management partner to take care of all of the financial headaches and let you get on with your true calling. But ah, are all RCM companies the same? You must be wondering, how do you set them apart?

Fortunately, one tell-tail sign of a successful RCM partner is their commitment to onboarding when you first join them. Often, an overlooked, under-recognized process, dismissed even as ‘nice to have’. But not here, oh no. When we onboard a new customer, we do it The AIMA Way.

“We know from experience; the long-term commercial operations of a healthcare business are greatly improved by thorough onboarding during the infancy of their relationship with an RCM provider. AIMA value this process; rather than just going through the motions, we see it as our opportunity to lay solid foundations upon which can help the physician practice or laboratory to become fully optimized for sustained growth” 

Patrick Richmond, AIMA VP of Global Operations

So, ask yourself, does your RCM medical billing partner cover all of these steps?

AIMA Onboarding Step One – Your dedicated account manager is with you from day one

Here at AIMA, we have an individual customer approach.  From day one, you have a dedicated account manager who will spend time getting to know you and your unique business. They are always available to answer any questions on a direct line number, no complex switchboards or chatbots here.  Our very own highly skilled revenue cycle managers will schedule weekly update meetings to outline any issues and address them before affecting your cash flow. 

AIMA Onboarding Step Two – Complimentary in-house training 

All AIMA customers receive a free hour-long training session. Topics covered include all aspects of compliance, workflow, a general overview of the billing codes and process, and strategies and timelines for credentialing and contracting.  We set clear expectations in terms of reimbursement timelines so that your healthcare business can address any cash flow concerns.

AIMA Onboarding Step Three – Total reporting transparency 

You will never need to ask us for a progress report; it is company standard procedure to provide regular time scheduled reports. We firmly believe relevant and timely data is the key to your understanding of your healthcare business’s financial well-being.  AIMA collate easy to read daily dashboards to indicate daily billing and payment posting details.  Weekly reports are sent on outstanding AR, exception lists, and expected payment projections.  We pride ourselves on the transparency we give to our customers.  24/7 access is given to the billing software and the stock reports to provide an accurate billing status picture.

Are you confident that your RCM medical billing partner covers all of these in their onboarding?

It is now time to look at some of the medical billing, coding, credentialing, contracting, and enrolment processes we go through on your behalf during the all-important – RCM Customer Onboarding: The AIMA Way.

  • Licensing

We all know, every business entity needs their license to operate in the state where they operate.  Medical practices need to get their license from the State Medical Board.  AIMA credentialing experts liaise daily with all the state medical boards, adeptly navigating the winding corridors of changing policies.  Furthermore, we also facilitate laboratories to obtain out of state licenses to accept samples from patients outside of their home state. Did you know, only five states impose this requirement? 

  • NPI Enumeration

As per the Health Insurance Portability and Accountability Act provisions, every US healthcare provider must have their National Provider Identification Number.  As you would expect, we specialize in both Type 1 and Type 2 NPI enumeration and have successfully enumerated hundreds of medical practices, laboratories, and individual physicians.

  • CLIA Certification

The Clinical Laboratory Improvement Amendments (CLIA) regulate laboratory testing and require clinical laboratories to be certified by the Center for Medicare and Medicaid Services (CMS) before accepting human samples for diagnostic testing.  There are three types of CLIA Certificates:  Certificate of Waiver, Certificate of Compliance, and Certificate of Accreditation.  Rest assured, AIMA works with CLIA agencies and accreditation agencies such as CAP and COLA to get the labs CLIA certified appropriate for the scope of their Independent Lab or Physician-Owned Lab.

  • Payer Mix Identification

With the correct certifications in place, the next step is to identify the right payer mix for your physician practice or laboratory. The AIMA medical billing team has years of experience within healthcare revenue cycle management. We are experts in allocating the best payer mix based on the practice’s geographical location and specialty.  This is a critical step in optimizing the revenue potential of the healthcare business.  The significant payers that any practice or lab should get credentialed or contracted with are:

  1. Medicare
  2. Medicaid
  3. COVID-19 HRSA Portal
  4. BCBS – Blue Cross. Blue Shield
  5. Aetna
  6. Cigna
  7. Humana
  8. United Healthcare
  • Medicare Enrolment

The very first step in credentialing and contracting is getting your Medicare PTAN.  This opens up a vast market in terms of Medicare and Medicare Advantage beneficiaries.  AIMA handles Medicare applications electronically using the PECOS system.  We are pleased to announce, we have expedited the Medicare approval process using the 1135 Waiver during this pandemic.

  • Medicaid Enrolment

The next patient population to target is Medicaid patients.  Medicaid pays for the healthcare expenses of low-income families.  If your practice is located in a low-income neighborhood, this will become a major revenue stream.  Whatsmore, AIMA handles all state Medicaid applications electronically, as well as paper, helping you get enrolled swiftly.

  • HRSA Set Up

COVID-19 HRSA fund was established to ensure free COVID-19 testing for the uninsured population.  Optum manages this portal, AIMA collaborates with the agency to ensure all our COVID-19 testing laboratory customers are registered appropriately to collect optimum revenue.

  • Commercial Payer Contracting

We deal with all the major commercial carriers and regional plans to ensure our customers’ businesses contract at the best possible reimbursement rates.  And as for rate re-negotiations for the existing arrangements, our longstanding relationships with network representatives will be a real shot in the arm for all your practice’s credentialing efforts.

  • Choosing the right EMR and PM

The AIMA team is adept at working with a multitude of electronic medical records (EMR) and practice management (PM) systems. We appreciate each software’s nuance and how it will work best for every speciality and practice size.  Our enterprise relationships with multiple EMR and PM vendors facilitate preferential pricing for your business.  As you would imagine, we also provide training and ongoing support for your chosen EMR and PM system.

  • Electronic Data Interchange (EDI) Setup

We have respected relationships with all major payers and clearinghouses. Your AIMA team liaise directly to establish the electronic data interchange set up to expedite electronic claims submission to every payer.  We also work on Electronic Remittance Advice to receive payment information electronically rather than on paper, avoiding unnecessary paper management hassles and helping the environment. 

  • Coding & Billing Strategy and Implementation

Our AIMA coding team enters a dialogue with you to understand the services provided and the panels offered in the case of labs.  We develop fully compliant coding and billing strategies to ensure your maximum revenue.  We make it our professional duty to keep ourselves updated with the latest insurance guidelines and advise clients on the right path to choose.

So, now you have learned about AIMA and how we value the customer onboarding process, let us get to know you and your physician practice or laboratory. Contact us today and start a conversation about how we can help to optimize your healthcare business for sustained growth.