RADIANT HEALTHCARE

Explore our services for adaptable healthcare outsourcing solutions.

Healthcare organizations often outsource when they need to, scale, reduce costs, and improve operations.

Radiant Healthcare does it better, partnering with clients beyond outsourcing to ensure their organizations can grow while providing the care patients deserve.

We minimize hiring and training costs associated with building large teams of in-house business processing staff and moving those RCM operations to outsourced centers. Through strategic alignment, and a platform refined over 20 years, we deliver unmatched agility and accelerated value creation.

SERVICE OVERVIEW

Revenue cycle management

The process through which healthcare systems bill for services and generate revenue is known as revenue cycle management (RCM).

The revenue cycle process comprises several steps, from a patient's initial appointment through the payor's acceptance of final payment. Radiant Healthcare helps with all these steps, including:

✓ Patient Registration: collecting key demographic information from patients, validating their medical insurance, and ensuring services are authorized
✓ Charge Capture: creating billable charges from medical services
✓ Claims: delivering and submitting medical billing charge claims to insurance companies
✓ Collections: working with insurance payers and patients to collect payments and manage denials and underpayments

(RCM) REVENUE CYCLE MANAGEMENT

RCM metrics and dashboards

Best practice-driven RCM performs at or above baseline measures on core metrics, including:

✓ Weekly total medical claims reimbursements
✓ Average days to payment, aged receivables
✓ Denial rates

RCM dashboards provide executives actionable insights by visualizing their organization’s RCM process health. They are critical tools for managing the revenue cycle in real-time. Radiant creates, enhances, and maintains dashboards using technologies like PowerBI or Tableau.

RCM is an integral part of any healthcare organization’s success. Let us help you grow and mature various RCM functions and improve your financial position.

(RCM) REVENUE CYCLE MANAGEMENT

Enhance workflows, risk-sharing models, and patient engagement. Adapt to market competition.

  • Failure to review and improve workflows can mean broken processes are further embedded into day to day operations. Prevent operational and technological surprises by fully leveraging parallel testing of complex data feeds, including electronic health records and other third-party applications.

  • The Medicare Access and CHIP Reauthorization Act (MACRA) requires greater visibility into risk-sharing models and incentives for Accountable Care Organizations (ACO) to deliver quality patient outcomes and bend the cost curve. Organizations must be able to model and predict the optimal Medicare Shared Savings Program (MSSP) and track progress to identify addressable problems. The industry also will see greater private-payer attention to risk-sharing agreements. RCM enables analytics to power insights, model scenarios, and progress tracking as businesses agree to financially impactful contracts.

  • Patient engagement plays a significant role in clinical outcomes and in facility or clinician ratings that impact revenue growth and patient retention. Navigating healthcare, coverage, and the ensuing payment affects the patient’s experience. RCM capabilities improve the patient experience by allowing scheduled appointments, shared medical records, coordinated referrals, patient liability estimations, clinician messages, refill requests, simplified statements, and diversified payment plan options.

  • Mergers and acquisitions in healthcare, physician practice acquisitions, and new lines of revenue such as virtual care, mobile treatment, and diagnostic centers are reshaping the healthcare industry. Each new initiative or entity represents the addition of multiple RCM applications, add-ons, complementary applications, and third-party integration points. This movement creates a disjointed view of the revenue cycle and interferes with the ability to take advantage of triggers to coordinate care and improve clinical and financial outcomes across systems.

SERVICE OVERVIEW

Clinician credentialing verification

Radiant nursing and clinician credentialing services streamline the tedious, labor-intensive, and time-consuming credentialing verification process. We use industry-leading software and best practice-driven operations to reduce credentialing time by as much as 50%. We assist providers and clinical staffing companies to improve their credentialing flow while lowering costs, increasing agility, and providing scale.

To make sure your team meets ever-evolving standards and upholds compliance, we handle your payer enrollment and credentialing. We perform background checks and license verification through continuous document expiration monitoring so you know which candidates are qualified.

CLINICIAN CREDENTIALING VERIFICATION

Improving accuracy, reducing costs, and cutting onboarding times with personalized care.

  • We ensure clinicians are ready to work by verifying education, certifications, and work history. We also shield your organization from legal and compliance risks.

  • We are equipped with efficient software that ensures the capture of proper and timely documentation while securing data.

  • Our software ensures staff operate in compliance by sending real-time alerts up to 90 days before an expiration date. Our credentialing services significantly reduce expensive manual workflows, giving you the ability to focus on other areas of practice management.

  • All your requirements will be managed by a committed Radiant Healthcare professional who works tirelessly to meet needs and minimize turnaround time.

SERVICE OVERVIEW

Payer enrollment verification

Provider enrollment is a critical part of reimbursement. Missing information, inaccuracies, and signatures can mean weeks and months of delayed reimbursement. And that means a loss of revenue. Provider enrollment demands meticulous attention to detail, consuming valuable time, and resources that could be better utilized elsewhere. Our team of experts specializes in navigating this complexity, meticulously managing every step of the process to guarantee flawless and efficient clinician enrollment.

By partnering with Radiant Healthcare, you're not just outsourcing a task – you're gaining a dedicated partner committed to streamlining your operations.

PAYER ENROLLMENT VERIFICATION

Ensuring timely provider enrollment with payers.

  • Our precise and swift enrollment services translate directly into accelerated revenue generation. By ensuring accurate and expedited provider enrollments, we empower you to capture revenue streams swiftly and efficiently, ultimately enhancing your financial performance.

  • Provider enrollment is a challenging process. We remove the burden to allow you to focus on growing your organization.

  • Our expertise spans all eligible provider types, encompassing various specialties and settings. We oversee the meticulous preparation and submission of provider enrollments, skillfully navigating the intricacies of payer validations. We also ensure ongoing accuracy of CAQH profiles, guaranteeing uninterrupted patient access to your exceptional care services.

  • We bring a wealth of experience in accurately outsourcing provider enrollment services. Our comprehensive approach identifies expired licenses, certifications, and documents, ensuring regulatory compliance. We also meticulously verify provider privileging, leaving no room for regulatory non-compliance.

SERVICE OVERVIEW

Technology enablement and data analytics

Leveraging technology to its fullest potential is imperative. Technology enablement, driven by data analytics and RPA, empowers organizations to navigate the complexities of modern healthcare with precision. Radiant Healthcare understands extracting meaningful insights from vast data sets and automating repetitive tasks can be arduous. Our experts integrate cutting-edge, secure technology into your operations, providing accurate data-driven insights and efficient process automation.

By partnering with Radiant Healthcare, you're not just embracing technology – you're embracing a future where actionable insights and streamlined processes are the norm. Our in-depth understanding of healthcare nuances and technological advancements ensures your organization stays ahead of the curve.

TECHNOLOGY ENABLEMENT

Empowering leaders with valuable insights.

  • Unlock the full potential of your organizational data with our cutting-edge technology enablement and data analytics solutions. These tools allow you to leverage the wealth of information within your operations, enabling data-driven decisions that enhance efficiency, optimize processes, and drive strategic growth.

  • Elevate your operational efficiencies and boost your productivity with our high value, robotic processing by automating repetitive tasks, reducing manual errors, and enhancing process accuracy.

CONTACT US

Ready to transform your healthcare operations?

Radiant Healthcare is here to catalyze your growth through tailored solutions in revenue cycle management, credentialing, payer enrollment verification, and technology services. Connect with us today for optimized, cost-efficient healthcare services. Your transformation begins here.