Durable Medical Equipment - Revenue Cycle Management
Generating Healthcare Impact
Despite strong growth, Durable Medical Equipment (DME) organizations are facing many challenges such as increasing complexity of insurance benefits and medical claims, and a shift to consumer-driven payment models, all of which have a direct impact on their revenues, cash flows, and margins.
Genpact helps DME organizations design, transform, and run intelligent revenue cycle management processes and operation to adapt to changing product and market realities, improving cash flows, collections efficiency, and reducing revenue leakage.
- Document management solutions for sorting and indexing, correspondence, and payment details
- Pre-order management solutions for reviewing Medicare, eligibility, pre-authorization, patient responsibility, collecting co-pays, providing financial counseling, and validating and completing orders
- Order fulfillment solutions including inventory verification and order fulfillment
- Claim production and billing solutions including HCFA 1500 and ICD-10, HIPAA 5010–compliant operations to review electronic claims, sending to payers (837P), acknowledgement from payers (997), and hard copy billing
- Payment receipts and cash posting solutions for electronic and hard copy payments, including denials (835) and post-audit of refunds
- Accounts receivables solutions including insurance follow-up, denial management, and self-pay collections
- Sales operations support/customer service support for patients, account managers, clinics, and outbound sales campaigns
Our Smart Enterprise Processes (SEPSM) proprietary framework helps DME organizations reimagine revenue cycle management operations by integrating effective Systems of EngagementTM, core IT, and Data-to-Action AnalyticsSM, helping them generate tangible business outcomes.
One of the top five U.S. healthcare payers identified US$4 billion of overpayment and curbed revenue leakage by proactively checking the integrity of claims and payments with Genpact's overpayment identification engine
A leading U.S. medical equipment provider realized $8.6 million in annualized business impact with a 42% increase in billing to cash conversion and improved sales force effectiveness through operational excellence, automated work prioritization, and improved forecasting
A leading medical equipment company grew annual revenues by $75 million and reduced working capital by US$9 million by transforming revenue cycle management processes, performing risk segregation and implementing a robust monitoring and reporting system