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Custom Software Application for Healthcare Revenue Cycle Management (RCM) and Bank Reconciliation Solution
Solution Description:
Healthcare Revenue Cycle Management (RCM) Transaction Reconciliation…Healthcare RCM teams often struggle reconciling healthcare claims with insurer payment transactions. This can be manually intensive and spreadsheet focused slowing down cash posting and recognizing revenue. TAP's RCM Bank Reconciliation Process (BRP) auto reconciles medical claims, based on defined rules and algorithms, integrating with various EMRs & banking vendors and providing RCM teams with streamlined, efficient and effective workflow and TAP's Actionable Information (AI) for optimal Healthcare cash posting and revenue recognition.Watch TAP Innovation Solutions in action!
Challenge:
We simply asked a Healthcare RCM team…Tell us about your Manual Efforts and SpreadSheets or MESS. And this 100 location, nationwide healthcare provider said…we submit our claims electronically through our practice management (PM) system just fine. However, we receive multiple insurer payments in 17 different bank lock boxes because we've acquired multiple practices with different banks and have not consolidated yet. We then pull this payment data into multiple spreadsheets each day and week, try to filter the data in a few different ways and then we try to match it up with the original claims in our PM system…all of this being performed in spreadsheets. We literally have a MESS with inaccuracies, errors and because this is so darn time consuming and confusing, we are spending WAY too much time looking for matching AND non-matching transactions and we are not able to report on any of this OR post cash and recognize revenue on time for our organization. We need HELP!
Number of Locations: 130
Number of Employees: 2700
Industries: Healthcare, Eye Care, Mergers & Acquisitions (M&A)
Solution
TAP quickly identified the Manual Efforts and SpreadSheets or MESS, reached into the Integrated Digital Toolbox and solved this MESS in 2 months. We first integrated with the PM system with TAP's Integration Fabric/ETL tools (NextGen) to daily pull the original claim transactions in our SaaS database platform. Then, using Robotic Process Automation (RPA), we integrated with Wells Fargo's system (APIs were too expensive) to pull insurer payment data with complex filtering logic built in. Next, with TAP's Integration Fabric, we auto compared the detailed payment transactions with the original claims to auto reconcile and match close to 70% of the transactions. This then allowed the RCM team to spend more time on those transactions that did not match. Lastly, TAP provided a secure Bank Reconciliation Process (BRP) App with 8-layer security for the team and leadership to view, manage and report on the matching and non-matching transactions. This solution created a savings of over $100k/year!
Integrated Systems
Categories: Custom App
Brands: Custom
Digital Tools:
C#, ASP MVC.net, SQL Server, APIs, SSIS, Azure Cloud Services, Multi-Tenant, Entity Framework, Microsoft Power BI, Microsoft SQL Server, SSIS, SQL Server Integration Services