Revenue cycle capabilities
Organized by stage: before submission, submission and follow-up, and payment visibility.
- 01
Prepare
- 02
Validate
- 03
Submit
- 04
Follow up
- 05
Reconcile
This is the full revenue cycle flow. It does not imply every stage is already automated: scope is defined by your operation, country and payer.
Before submission
Eligibility & authorizationsOrganize policy and plan information, supporting requirements and authorization status before the account is submitted.Scope is defined by your operation, country and payer.See the platformDocumentation & validationAssemble supporting documents, identify missing fields and review account completeness against configured requirements.See the platform
Submission and follow-up
Claims submissionPrepare submission packages, send them through agreed channels where supported, and retain acknowledgments and reference numbers.Scope is defined by your operation, country and payer.See the platformClaims trackingTrack each account's status, pending requests, responsible staff and next action across the agreed workflow.See the platformDenials & appealsOrganize objection reasons, supporting evidence, corrections and the responses sent.Scope is defined by your operation, country and payer.See the platform
Payment visibility
Payment reconciliationCompare remittances and payments with submitted accounts, flag differences and organize review.Scope is defined by your operation, country and payer.See the platformAccounts receivablePrioritize outstanding accounts by age, amount and next action, and coordinate follow-up with each payer.Scope is defined by your operation, country and payer.See the platformOperational & financial visibilityViews of aging, pending accounts, response times, rejection reasons and reconciliation differences.See the platform
How an implementation is scoped
Typical touchpoints are payer portals, clinical and hospital systems, accounting systems and files. Support for each is confirmed during implementation.
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