Revenue cycle management
Revenue Cycle Management, Run as One Operation
Most revenue leaks at the joins. Eligibility is checked but not recorded, a charge is entered correctly against the wrong date of service, a denial is worked but never categorized, so the same denial arrives again next month. We run the functions as one operation, on your systems and your rules, so the joins are somebody's job.
What we handle
Any of these can be taken on its own. Taken together they close the loop, which is where the compounding is.
- Patient registration and demographic entry
- Insurance information capture and validation
- Duplicate record identification
- Eligibility and benefits verification
- Prior-authorization requirement identification
- Charge entry and charge validation
- CPT, HCPCS and diagnosis code data processing
- Modifier and date-of-service validation
- Electronic and paper claim submission support
- Claim status tracking and rejection identification
- Claim correction and resubmission support
- ERA and EOB payment posting
- Adjustment, denial and patient payment posting
- Deposit and payment reconciliation
- Insurance and patient AR follow-up
- Aging analysis and account prioritization
- Underpayment identification
- Denial categorization and root-cause analysis
- Appeal and reconsideration preparation support
- Denial trend reporting and preventive recommendations
Your queues, your system, the same people on them every day.
How the work runs
The same sequence every day, with a named owner and a documented exit condition at each handoff.
- 01Register
- 02Verify
- 03Capture
- 04Submit
- 05Post
- 06Follow up
- 07Resolve
Patient Registration & Demographic Management
The cheapest place to fix a claim is before it exists. Registration is where most avoidable denials are created, and where they are cheapest to prevent.
- Patient registration and account creation
- Demographic entry and verification
- Patient information validation against source documents
- Duplicate record identification and flagging
- Insurance information capture
- Coverage and policy detail validation
- Data quality checks against your registration standards
Insurance Follow-Up
Following up on a claim is not the same as checking its status. The work is deciding what the status means and what has to happen next.
- Claim status follow-up with the payer
- Payer communication and call documentation
- Outstanding and pending claim tracking
- Documentation requirement identification
- Payment status verification
- Escalation of claims that stop moving
Patient Billing Support
Administrative support for the patient-responsibility side of the balance, handled with the same documentation discipline as the payer side.
This is administrative billing support only. Deeva does not provide clinical services, clinical advice, or any service requiring a licensed clinician.
- Patient statement support
- Account inquiry handling
- Payment-related administrative support
- Outstanding balance follow-up
- Account documentation and notes
The delivery approach, in full
Seven stages, in this order, every time. The point of writing it down is that you know which one you are in and what has to be true before the next begins.
- Understand
- Your workflows, systems, payer mix and the reasons behind the exceptions.
- Transition
- Documented SOPs, access provisioning and a staged handover of volume.
- Train
- Team trained on your process, not a generic one, and signed off before going live.
- Operate
- Daily production against the agreed scope, queues and turnaround expectations.
- Measure
- Accuracy, productivity and turnaround reported on the agreed cadence.
- Improve
- Error categories and denial patterns drive corrective action upstream.
- Scale
- Capacity added against your forecast once the process is stable.
Understand
Your workflows, systems, payer mix and the reasons behind the exceptions.
Transition
Documented SOPs, access provisioning and a staged handover of volume.
Train
Team trained on your process, not a generic one, and signed off before going live.
Operate
Daily production against the agreed scope, queues and turnaround expectations.
Measure
Accuracy, productivity and turnaround reported on the agreed cadence.
Improve
Error categories and denial patterns drive corrective action upstream.
Scale
Capacity added against your forecast once the process is stable.
What you get
- A documented SOP per process
- Built from your workflows during transition, version-controlled, and updated when your payers or systems change.
- A named team with a named lead
- The same people on your queues each day, with an escalation path agreed before go-live.
- Work queues in your system
- We work inside your practice management or billing platform. Nothing moves to a tool you cannot see.
- Exception handling, not exception dumping
- Accounts we cannot progress come back with the reason and the next action, not as an unexplained backlog.
Reporting cadence
- Daily
- Production and queue status against the agreed scope.
- Weekly
- Exceptions, escalations and anything blocking throughput.
- Monthly
- Accuracy and turnaround against the agreed measures, plus denial categories and the corrective actions taken.
How it is measured
KPIs and SLAs are customized according to the client's process requirements and contractual scope.
These are the measures we report on. The targets against them belong in your agreement, where they can be negotiated and enforced, rather than on a web page where they cannot.
- Accuracy, sampled at transaction level
- First-pass quality
- Claim processing turnaround time
- Eligibility verification turnaround time
- Payment posting accuracy
- AR follow-up productivity
- Denial resolution and recurrence
- Aging bucket movement
- Process compliance against the SOP
- SLA compliance
Start with the part that is costing you most
Send us your current volumes, the functions you want to move and where the process is breaking. We will come back with a delivery model, a team structure and a transition plan.