Optimal Revenue Cycle Management Solutions partners with you to navigate the internal complexities of health plan billing, claims aging, UM, and provider registration. We are uniquely qualified to guide our providers and optimize revenue so they can focus on providing quality care to their patients. We are your medical operations specialists!
Eligibility and benefit information is essential for effective billing and revenue management. We offer eligibility and benefit verification to help simplify and streamline the process to collect your revenue. OPTIMAL RCMS can obtain accurate information on your behalf or we can capture and verify the information you submit to us.
We submit claims electronically to most carriers from day one. Claims are processed within 72 hours of receipt, and payments are typically made within 14 days. We provide a high level concentrated follow-up process on all claims until they are paid. Optimal provides Accounts Receivable Management whereby we successfully manage this resource intensive process within stringent time frames and we ensure adherence with regulatory and payor time frames.
 | Increasing your rate of Payor reimbursements? |
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 | Eliminating hours spent on the phone with difficult health plans and getting nowhere? |
 | Collecting aging receivables? |
 | Increasing the bandwidth of your staff so they can focus on patient care and less on billing? |
 | Reducing staffing and overhead costs? |
 | Full life cycle billing support – authorizations, claim submission, denial and appeal management |
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 | Experts at payor enrollment and working with out-of-network providers |
 | Experienced payor contract negotiations |
 | Verification of benefits available |
 | In-house clinical team |
 | California based medical billing support team. |
