REVENUE CYCLE MANAGEMENT

Analytics driven, technology enhanced, perfected by people.

Globonics Revenue Cycle Management offers a complete solution, from beginning to end. Our proprietary GoRev software system was developed in house from the ground up and utilizes thousands of rules to insure every claim goes out with the highest possibility of adjuciating the first time it is submitted. We utilize it exclusively to manage hospital, ASC, and physician practices.

Our principles are simple and straightforward.  We are committed to our people and products.  We hire the right people and constantly train them.  We continue to develop an industry leading software platform and regularly add new features. Our committment to these principles has proven success, time and time again.

 People:

  • We believe in quality over quantity.  We only hire the highest caliber people and then train them on our proprietary processes and software. Our RCM specialists go through rigorous training utilizing many internal and external resources.  Some of these include:
    • Lumosity (Yes we make our people play games on the clock!).   A smarter team is a smarter revenue cycle.
    • Litmos Healthcare This system provides a great foundation in RCM offering a four-tier certification approach.
    • Criteria Corp We utilize this system to test all applicants before we hire them.   We continue to utilize this system to deliver all internally developed training material testing.
  • We are entirely virtual company.  We have learned from past challenges where we had over 50,000 square feet of office space.   Going virtual has allowed us to reinvest those brick and mortar costs directly into our people. Having an entirely work-from-home team provides us with countless efficiencies and a happier staff.  Win, Win!  We provide all of our employees with top of the line office equipment for their home offices and we even go as far as teaching them how to properly document and take home office tax credits

Product:

  • We exclusively utilize the GoRev platform for all of our RCM work.  Check out more about it at GoRev.com.
    • We have developed integrations with nearly all hospital platforms on the market from Meditech to Medisoft.  Once we have developed a set of extraction processes for a particular system we can copy and paste them into any new environment running the same system in as little as 3 days.  This allows us to rapidly implement your RCM services.  Many times when you transition RCM to a new entity you go through the dreaded cash flow dip for 90 days.   With us, claims will go out within 10 days of the start of implementation.  This compounded with our ability to immediately identify all of your past claims issues and refile instantly eliminates this cash flow dip.
    • Since we are the original developers of GoRev, we can add customizations as needed and regularly do.  New features get released weekly.  This allows us to respond to industry changes nearly immediately.  For example, when CMS releases new device-dependent procedures we can create and apply a system coding edit that notifies our team whenever the specific CPT is used and no implant HCPCS was detected.
    • We already have industry-leading feature sets developed:
      • Real-time eligibility: This system connects directly to insurance carriers and pulls down all the intricate plan details; coinsurance, deductible, out of pocket max, etc. 
      • Patient Estimation:  Utilizing the detailed data obtained from real-time eligibility, our system can provide your staff a very accurate estimate of their patient responsibility.  This allows them to collect up front.  $1 collected up front is worth at least $2 collected after the patient leaves.
      • Contract Management:  We can load your individual payer contracts down to every last detail.  We then utilize this module to enforce compliance (if the insurance carrier doesn't pay you correctly we know the day the payment hits and appeal next day).  We also utilize this feature to notify you directly when a claim is very close to hitting specific contract carveouts such as implants only being payable after cost exceeds $1500.
      • Denial Management:  Our system is capable of integrating directly with Zirmed's denial management platform and operating entirely on its own.   We consume insurance carrier 835 payment files and group them into like-issue work buckets.  Our employees take it from there.
      • Automated Appeals:  This feature allows our employees to be more efficient.  Generating an appeal is as easy as selecting the proper template and clicking generate.  The system pulls in all data, you tweak, and release.   We have even taken this one step further by queuing up automated appeals for our employees to review and release quickly.
      • So much more

Process:

  • Our process is under persistent development utilizing all of the above.   We do not employ one single technique to constantly better our process. Instead, we take pieces from Six Sigma, our own experiences, and most importantly our clients and team member's feedback.   
  • Implementation of our RCM services happens as follows:
    • Step 1: We obtain access to your system's data with one of three methods
    1. Directly access its database environment (SQL, DB2, Cache...we can hook into anything)
    2. Access your data through backup files
    3. Implement an HL7 interface with the help of your vendor
    • Step 2: We load all of your data into our GoRev SQL databases.  This instantly unlocks all of our potent features and claims edits.
    • Step 3: Our implementation team follows our structured new client process and:
      • Reviews your entire charge master looking for invalid CPTs, deleted CPTs, missing charge items (new CPTs, implants, supplies, etc), under or overpriced items, and so much more
      • Reviews and releases the list of the flagged prior date of service accounts.  These will have various issues identified from missing charges to invalid coding.
      • Implements concurrent coding for hospital systems and specialty-specific coding for all others
      • Implements denial management workflows
      • Prepares initial executive summary implementation report
    • Step 4:  We meet with you for our first RCM executive meeting and go over all of the identified issues.   We will implement procedures with your various departments during this visit and subsequent visits so they can assist our team; finding missing implant invoices, clarifying physician documentation, and more.

We would be happy to provide a demonstration upon request.  Contact us today!



Cash Collected by Globonics since 2015