CareMount Medical, New York State’s premier multispecialty medical group, has expanded its relationship with healthcare software company, RCxRules, to improve claims performance under both value-based and fee-for-service contracts.
“RCxRules’ HCC coding automation software has been essential to CareMount’s continued success with value-based contracts. By joining forces with RCxRules on the revenue cycle rules front, we expect strengthened financial success under fee-for-service contracts,” said Kevin Conroy, CFO and Chief Population Health Officer at CareMount Medical.
CareMount has been using RCxRules software to identify HCC coding gaps under its value-based contracts and will now implement the RCxRules Revenue Cycle Rules Engine to assist with the group’s claim scrubbing and submission process. The software automatically reviews clinical charges in providers’ electronic health records (EHRs) to ensure that accurate and complete claims data is captured before claims are submitted to payers.
CareMount is comprised of over 650 physicians who serve more than 665,000 patients in the Hudson Valley and New York City. The organization plans to run all clinical charges from its EHR, Pathology, and Radiology systems through the RCxRules software for automated review and correction before they enter CareMount’s Practice Management (PM) system. The software enables CareMount to create rules tailored to its practices, providers, specialties, and payers, resulting in a more robust and accurate review process.
RCxRules software automatically corrects most charge errors without manual intervention, and charges requiring further review will be flagged in the RCxRules dashboard for coders or billers to resolve. This exception-based workflow increases productivity and efficiency by enabling CareMount’s billing team to focus solely on high-value charges that require manual intervention.
“The RCxRules revenue cycle software will automate the charge review process and automatically correct routine data quality issues before charges go to the PM system,” said Susan Monaco, Chief Revenue Officer of CareMount Medical. “We expect this will increase efficiency and productivity and help ensure correct payments the first-time claims are submitted.”
To learn more about RCxRules Revenue Cycle Rules software, visit: www.rcxrules.com/revenue-cycle-rules-engine.
Founded in 2010, RCxRules helps healthcare organizations succeed with both value-based care and fee-for-service billing models. The automation technology ensures compliance and coding accuracy with healthcare's complex regulatory and reimbursement rules. By automatically reviewing charges for coding accuracy before claim creation and automatically fixing charges with routine data issues, RCxRules negates the need to "hunt" for errors. Organizations can spend their time focused solely on the most high-value coding errors. RCxRules addresses coding issues before they impact revenue and delivers claims with the most accurate financial and HCC data—every time, guaranteed. For more information, please visit: www.rcxrules.com.
CareMount Medical, P.C. is New York State’s premier multispecialty medical group, providing comprehensive care of the highest quality to over 665,000 patients. CareMount has more than 45 locations throughout Westchester, Putnam, Dutchess, Columbia, and Ulster counties and New York City. CareMount’s 650 physicians and advanced practice professionals cover more than 50 medical specialties. CareMount is affiliated with world-class medical institutions, including Massachusetts General Hospital and Northwell Health. CareMount offers on-site laboratory/radiology services, endoscopy and infusion suites, and operates eight urgent-care centers. CareMount physicians are featured in respected Top Doctors and Best Doctors listings, nationally and regionally. For additional information please visit: www.caremount.com.
CareMount Medical is a registered service mark of CareMount Medical P.C.