Our Core Services

Healthcare Consulting

OSP’s team of experienced healthcare experts offers quality healthcare consulting services for providers and health plans. Our team includes experts on enterprise software platforms, US government programs, digital innovation, and business operations.

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Enterprise Applications

OSP is proficient and experienced in building robust enterprise applications to address your complex and sophisticated software needs and execute your digital transformation lifecycle. We have comprehensive customized tools to solve your healthcare challenge.

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Healthcare Solutions Enhancement

Optimizing the healthcare system is essential for better productivity and quality performance. OSP’s team of developers can enhance and upgrade the healthcare solutions in modules, security, or interoperability sections with new custom components.

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Dedicated Quality Assurance

OSP’s QA team can resolve the challenges of disrupted workflow and application safety. We offer assurance in product quality with multiple levels of quality testing, including usability, performance, localization, and security testing.

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Explore Revenue Cycle Management

The traditional reimbursement models in healthcare are facing paramount transformation to mutually beneficial healthcare cost management solutions. OSP is at the forefront of providing custom cost containment solutions to the healthcare payers that play a vital role in reducing overutilization, identifying the areas to minimize healthcare spending, and enhancing transparency.  

Our tailored cost containment software solutions empower the payer organizations with robust knowledge management and utilization of leading Medicare benchmarking tools. We strive to automate and improve the claim cycle and transparency by auditing medical accounts, PPO network administration, and PPO repricing. 

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The lengthy and tedious healthcare revenue cycle is experiencing a paradigm shift in its management with OSP’s highly customized money transfer application software system. Our remittance management software solutions relieve the intense pressure on healthcare systems overloaded with payments-related paperwork rising performance expectations.  

OSP’s first-rate custom remit management software solutions enable providers to automatically post accounts receivable and swiftly balance payments to the original claim. Our healthcare payment solutions are built to ensure the maximum efficiency of your business with reliable and sophisticated compliance and are easily accessible with cloud architecture. Our integrated payment management solutions help you free yourself from endless claims filing, manage EOB claims, and effectively identify denial reasons.

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Healthcare payment systems are the structured payment models that help patients pay for their treatments through direct copay or insurance coverage. The paper-based healthcare payment models are the things of the past. Health care is transitioning from healthcare payment systems based on the volume of services provided, also known as fee-for-service, to value-based care, where healthcare payments are based on the value of those services.  

OSP has experience in building a wide variety of healthcare payment solutions for myriad facilities as per their needs. We can customize healthcare payment systems that help you navigate the transition from fee-for-service to value-based payment. We can customize healthcare payment models for a broad spectrum of payment systems such as Medicare, inpatient PPS, outpatient PPS, MACRA & other physician payment, long-term care hospital PPS, and more. 

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Healthcare RCM is a financial process utilized by US-based healthcare systems to track the revenue received from their patients from appointment scheduling to the final payment of medical bills. Healthcare RCM companies track a patient’s journey described through a cycle of encounters from admission to adjustments of accounts receivables. 

The Healthcare RCM process is the strategy used by healthcare provider companies to save time and money. Healthcare revenue cycle solutions help streamline the medical practice’s financial side to get more money per patient with lesser efforts in a shorter time. Healthcare revenue cycle management companies leverage healthcare RCM solutions to eliminate the traditional system, enhance revenue margins and prepare for value-based payments by examining possibilities across the complete revenue cycle.

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OSP’s Healthcare Specialty Billing Solutions caters to the billing needs of healthcare providers who are expanding their footprint by employing or affiliating with multi-specialty physician groups. Our multi-specialty billing services are instrumental in offering comprehensive RCM solutions featuring interfaces to ADT, EMR, and electronic charge capture systems to minimize errors and delays in the billing process. With our expertise and domain knowledge, we create specialty billing software solutions that automate and bring efficiency to the rigorous workflow in each healthcare specialty offering. Our multi-specialty billing software solutions manage charge entry, claims to scrub, medical claims filing, payment posting, patient billing, denial management, A/R follow-up, and comprehensive reporting. 

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Let’s Build Your Software

IT Solutions We Deliver

Revenue Cycle Management Software Development Services

Industry

Customized Revenue Cycle Management Solutions 

  • Develop comprehensive inpatient and outpatient management solutions
  • Streamline financial workflows to boost reimbursement and satisfaction
  • Leverage automation technology to track the status of patient encounters 
  • Facilitate seamless claims submissions and track claims 
  • Effectively manage denials and optimize reimbursement results
Industry

Integrating EHR/EMR with RCM Solutions 

  • Custom-built APIs to integrate EHR and EMR 
  • Optimize RCM tools to facilitate seamless interoperability
  • Ensure FHIR and HL7 data standards and other regulatory compliances
  • Automated data entry and smooth interchange of crucial PHI 
  • Minimize errors and inaccuracies in claims
Industry

Integrating RCM with Third Party Application

  • Facilitate integration with practice management solutions
  • Incorporate RCM with telehealth and RPM applications
  • Streamline digital payments by integrating with specific apps
  • Connect RCM tools with healthcare tools
  • Facilitate easy access to financial information

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Success Stories

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Solutions We Offer

Latest Talks

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Everything You Should Know About Healthcare Revenue Cycle Analytics

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How to Generate Revenue for Your Care Practice Using Telemedicine?

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Introducing Provider Revenue Cycle Management – Must-Have Features for Maximum ROI

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Why Providers Should Leverage Patient Portals in Healthcare to Drive Better Performance and ROI

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How to Improve Healthcare Revenue Cycle Management through Software Automation

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5 Common Myths About Healthcare Revenue Cycle Management Debunked by the Experts

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Frequently Asked Questions

The financial process that practices and hospitals utilize to manage the administrative and clinical functions connected with claims processing, payment, and revenue generation is known as healthcare revenue cycle management. It identifies, monitors, and collects revenue from patient service. RCM’s goal of improving provider revenue prioritizes the patient over everything else. Revenue cycle management boosts provider revenue while reducing time spent on administrative and clinical tasks. This involves allocating more resources and time to value-based care for the patient and their treatment.  

The purpose of revenue cycle management solutions is to identify and resolve any areas of friction in the provider’s revenue cycle. Care providers can maximize claim reimbursements and improve patient service revenue with efficient revenue cycle management. Furthermore, healthcare providers can get paid for their services more quickly by eliminating technical problems, claim denials, and fraud investigations. Also, they can save thousands of dollars on fixing inaccuracies, appealing claims, and detecting fraud. And with this additional revenue, providers can invest in patient care or boost their financial performance.  

A standard revenue cycle management software has two components: the front end and the back end. The front end oversees patient interactions, while the back end oversees claims processing and reimbursement. The front end of healthcare revenue cycle management solutions is the face of a hospital or medical practice. When a person seeks services from a healthcare organization, they meet departments and staff affiliated with the front end. Scheduling, patient registration, eligibility and authorization, and upfront patient collections are all important front-end obligations. The revenue cycle continues to the back end after providers do a patient visit and undertake clinical documentation and coding tasks. Revenue cycle management professionals handle claims administration, medical billing, and final patient financial responsibility collections on the back end.  

It would be an understatement to suggest that regulating the full revenue cycle management process is complex. More skilled people on hand to support the various revenue cycle operations can strain medical practices’ resources. However, it becomes a much more difficult task when providers have to account for compliance and the ever-changing rules and regulations governing the healthcare industry. Prioritizing revenue cycle management optimization is a key step for hospitals to deliver value-based care. However, employing more workers or redesigning operations can be expensive and time-consuming. Providers can increase efficiency in their practice by outsourcing to professional RCM vendors. It enables the medical practice to concentrate on what they do best while professionals manage processes that align with their skill set.  

One of the challenges that providers encounter is the inability to get paid soon after aftercare services are rendered. In fact, over half of healthcare leaders recently acknowledged that the most critical challenge their practices deal with is collecting payments. Besides, practices need more resources and tools to manage RCM effectively. As a result, team members spend far too much time on RCM rather than focusing their efforts on other critical areas of operations. Coding problems, such as upcoding, unbundling codes, inappropriate modifier use, and unlisted codes without documentation, are another challenge of RCM. Above all, many healthcare providers need help to gain the insights they require to determine the best path forward and ensure their approach to RCM is optimum 

From filling out paper claims forms and verifying a patient’s insurance coverage, usually over the phone, to finally getting paid and dealing with claim denials, the RCM process was manual, slow, inefficient, and error-prone. Information technology integrated to build revenue management solutions has dramatically improved the number of clean claims by quicker and more accurate submission to different payers. Technology also helped properly track the claim progress and handle denials. This reduction of costly denials and errors is decreased by enhancing the initial accuracy of the claims process, from coverage verification to final payment posting.  

RPA and AI incorporated in revenue cycle management software promote efficiency, decrease errors, improve financials, strengthen employee engagement, and improve the patient financial experience when fully adopted and optimized. The capacity of RPA and AI to streamline revenue cycle management is one of its most appealing benefits. Automation ensures speed and precision while allowing employees to focus on higher-value duties. Conversely, AI can evaluate massive volumes of data, including claims, payments, and denials, to provide firms with insights into their RCM process. These insights can help revenue cycle analysts and team members enhance their procedures and RCM initiatives to increase revenue.  

The current trends in revenue cycle management software solutions are automation of processes, patient-centric approach, value-based care, and data analytics with business intelligence. Process automation is a trend altering the healthcare revenue cycle management (RCM) business. AI and machine learning are key in automating RCM operations. A patient-centric approach in RCM is a trend that places the patient at the center of the revenue cycle. It includes a move from a traditional healthcare model centered on healthcare providers and insurance firms to one centered on patients. Another RCM trend is value-based care, which emphasizes the value of care services to improve patient outcomes and reduce costs. Finally, data analytics and business intelligence are RCM advancements that include using technology to collect, analyze, and understand data to improve business decisions.  

Predictive analytics is a game changer in healthcare revenue cycle performance because it can estimate revenue and detect and fix revenue-related issues before they arise. The insights acquired also equip healthcare firms to improve revenue cycle procedures, educate employees and doctors on best practices, and proactively resolve payment concerns with payers. Furthermore, predictive analytics lets providers predict which claims will be denied before submission. This allows staff to modify claims before submitting them, enhancing clean claims rates. Providers can also employ predictive analytics to manage denial work better, focusing staff attention on high-value rejections that the system is highly likely to overturn.  

Providers may need to refocus their revenue cycle management strategies to include more data analytics tools, population health management, and improved patient billing processes to allow an effective shift away from FFS reimbursement to VBC models. Furthermore, even before the advent of value-based care, developing front-end revenue cycle management processes was a big concern for many healthcare providers. However, as providers continue introducing alternative payment methods, gathering patient data in advance and engaging patients in their healthcare decisions has become increasingly vital for boosting revenue and improving RCM.