Providing high-quality patient care is a priority of every healthcare service provider. However, when the service providers oversee administration work, manage expenses, billing and handle the first stages of patient accounts, it creates a scenario where seamless execution of the transaction is crucial.
While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is where healthcare revenue cycle management comes in.
Healthcare revenue cycle management is the financial process facilities use to manage the administrative and clinical functions associated with claims processing, payment and revenue generation. The process consists of identifying, managing and collecting patient service revenue. The financial strategy is crucial to ensuring healthcare organizations stay in operation to treat patients. Facilities use healthcare revenue cycle management to collect profits and subsequently keep up with expenses.
Enabling a plethora of outstanding services that contribute to enhancing the operational processes of healthcare service providers is Scintillate RCM HealthCare LLC, a cost-effective Revenue Cycle Management Medical Billing company that allows the providers to focus on what they do best, i.e., caring for patients while bringing transparency, and responsiveness in the business.
Being a perfect outsourcing partner, the company implements an AI-based innovative solution that targets key areas of improvement, such as—placing tools in place to control or eradicate errors in the Data process, maintaining adjustments or effective follow-up on no-activity claims, conversion of paper transmissions to EDI, and increase in Cash liquidation rates—to execute and improve end-to-end Healthcare Revenue Cycle Management and Capital finance.
Under the proficient leadership of Hari Shankar, the CEO, the company operates on a scalable business model that not only meets the business demands quickly but also delivers ‘best in class’ quality output that is HIPAA compliant.
The Commencement
Scintillate RCM HealthCare started in July 2018, dealing with US doctors and hospitals. The company works on their behalf for insurance and patient handling procedures. It’s been four years and Scintillate RCM has grown in terms of client base and revenue across the US and India. Besides these two countries, the company also plans to expand its services to the UAE market, seeing a scope in medical billing as it has the same billing system as the US.
Hari has been serving the US healthcare market since 2006, climbing the ladder from junior to senior management across multiple companies there. His work was based on a three-year plan. That’s when he decided to start a company of his own. Following this thought, he returned to Chennai, India and established a company.
Embracing the Vision and Mission
Scintillate RCM manages to drive the team forward and out through challenging times by believing in perseverance and resilience, which are its core values. These values are cultivated within each employee from the beginning to achieve goals efficiently.
Secondly, trust plays a significant role in the company’s business. Cultivating a sense of trust among the employees is useful when building a meaningful relationship with the clients. An established trust encourages the employees to take responsibility in a timely manner for any escalation or query that may come up and make the required efforts immediately.
Assurance of Reliability
Appropriate outsourcing is essential when a doctor or a hospital is handling a lot of patients on an everyday basis. Healthcare providers are often entitled to managing their patient’s finances and administration, making it difficult to focus on treating them with quality care.
However, by outsourcing RCM, healthcare providers could reduce their workload, perform all the administration of their partners, and focus on treating more patients with quality care. Scintillate RCM is here for just that. It ensures that all the administrative tasks are taken care of, with revenues falling into their places.
The company takes care of all the aspects of handling the revenue cycle process for healthcare providers based in the US market. Starting from coding, building and posting AR, to denial management, all services and functions are taken care of. Despite the competition in the market where businesses offer the same set of services, Scintillate RCM stands different by relying on AI-based technology. It aims to reduce the providers’ man-hours and costs and increase ROI by integrating applications and tools.
Take, for instance, medical coding. Say, a patient visits a doctor with a complaint that he’s having a headache. He elaborates on his problems and related medical issues, in response to which the doctor prescribes some medication. The patient takes the prescription from the doctor and goes for treatment. Medical coding is where the patient’s diagnosis, i.e., a headache and procedures, i.e., an X-ray and paracetamol have their respective codes that come under ICD-10 and CPT-4. This form of coding is a primary function of the RCM process. But the authorities in the coding department often tend to make mistakes, as a result of which payments from the insurance are delayed or lost.
Scintillate RCM eliminates this error and performs accurate coding through Artificial Intelligence and automation, ensuring the payments are no longer delayed.
The company has patented multiple tools and applications within the US and India that help its clients to control their errors in coding, demo entry, cash entry and cash posting areas. It understands the importance of running a business that may lose revenue in the existence of an error.
While humans are prone to making mistakes, applications don’t. For this reason, the company has submissions, machine learning, artificial intelligence and incorporated tools that could help the clients in making zero errors, all of which are reviewed with 99% accuracy by its employees, who are ICD and CPC-certified professionals.
This brings a key advantage to the company as it can ensure its clients—an increase in AR cash liquidation rates, gross collection ratio, net collection ratio, and control towards adjustments. In addition, if a team of ten employees is working together on a task, then by using an automation tool, the need for manpower decreases, and 10% of the requirement could be eliminated, saving costs and profiting from the investment.
Scaling the Horizons
In general, healthcare providers usually look for a solution to reduce the losses that they experience. Hence, Scintillate RCM’s salesforce, based in the US, begins by proposing a plan to its clients that involve a detailed and descriptive analysis of their current problems, followed by ways to handle them affordably. When these healthcare providers realize that they no longer have to look after their workflow revenue cycle but simply rely on specific tools and applications, they buy in and develop a sense of trust toward the company’s services and products.
It’s the trust factor through which Scintillate RCM has come a long way in building relationships with its clients. It has an entire portfolio of client testimonials that demonstrates its position in the market and helps it grow further in accordance with healthcare needs.
Looking forward, the business is heading towards a client growth perspective by partnering with more EHR and EPM providers to create a platform where all the hospitals and healthcare providers could be a part of the platform. Thus, whenever there’d be a requirement in terms of action, they could reach out to the respective professionals.
On this note, Scintillate RCM is expanding across different states of the US, providing multiple specialties to seek more clients and expand the business portfolio. Next, the company focuses on the UAE, as the country is a replica of the US; when it comes to healthcare, Scintillate RCM is currently setting up a business model there and is planning to employ the citizens of the UAE there.
From the business perspective, Hari believes in himself being updated and upgraded along with his employees. He states, “As a company, we motivate our employees to join any courses or curriculum that will help them improve and grow.” Hence, the company will continue to change and improve the lives of its clients and employees.
CEO’s Thoughts on Turning Challenges into Opportunities for Growth
I’m a first-generation entrepreneur who started everything from scratch. It was in 2014 when I asked myself, “Why not start a company and make things better for our clients and employees? Why not change lives?” Although it was just a thought, ultimately, I started the company.
It ran well until the pandemic hit us, and we lost control over the business. We had to lose our people and money. But ultimately, we were entrepreneurs. We learned from our mistakes and bounced back. We started afresh, with a new plan in mind regarding innovations and inventions within the industry, as a way to seek more clients. That kept us going and will do so forever.
I also strongly believe in my employees. Without them, there’s no performance, no reputation and no clients. Hence, I don’t consider myself to be a boss, but rather a leader to inspire and motivates them to perform more than what’s expected.
For those who aim to become an entrepreneur in the industry, I would suggest that you never invest all your money into your unique business idea, as there will always be mishaps. Just make sure to pump 50% of the money, keeping the rest 50% of the money as a backup when you face failures which are bound to happen 90% of the time.
Secondly, people will always tell you, “No, there’s a risk in becoming an entrepreneur.” You will also have people who will equally encourage and motivate you. So be bold and brave. That’s half the success that you’d achieve there.
Lastly, never assume that you’ll start a business and succeed immediately. That’s not going to happen. Rather, set practical goals and vision. Entrepreneurship is when you accept the thought that you will make mistakes regardless and learn from them. You have the liberty and strength to handle problems, overcome struggles, accept failures and succeed.
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