Guide to Adit's Revenue Cycle Management (RCM)

Guide to Adit's Revenue Cycle Management (RCM)

Revenue Cycle Management, or RCM, is a business process used by healthcare providers to ensure they are paid for the services they provide. RCM encompasses a wide range of specific tasks, from patient registration and  insurance verification all the way to billing and collections.

At Adit, we offer a variety of features that help with many parts of the RCM cycle:
  1. Online Scheduling and Patient Forms, for patient registration
  2. Insurance Verification
  3. Payment Posting
  4. Account Receivable
  5. Adit Pay, for patient billing
  6. And more to come in the future!
Within the Adit platform, you’ll find an RCM module where you can easily access our Insurance Verification feature. Our other features related to the RCM process can be found in their own modules.

Continue below for a walkthrough of the RCM module and Insurance Verification feature and for a selection of Frequently Asked Questions.

FAQ

What is RCM?
RCM stands for Revenue Cycle Management. At Adit, we currently focus on the Insurance Verification step of that cycle.
How do I sign up for Adit’s Insurance Verification service?
Insurance Verification is an add-on service that you can sign up for by contacting our Upgrades team!
How do I set up Adit’s Insurance Verification module?
A member of our team will walk you through the setup process, but here are some of the settings you will configure:
  1. How far ahead of an appointment to trigger the verification
  2. How often to re-verify a patient
  3. If you want to attach a PDF or a note with the verification results to the patient’s file
  4. Which treatment codes to check when doing an Advanced verification and a Basic verification
  5. If we should verify new patients, existing patients, or both
  6. If we can contact your patients to request additional insurance information
  7. All of the insurances you accept and your logins to their online portals

See our article on How To: Set Up Insurance Verification for a detailed walkthrough of the configuration process.
What is the difference between Basic Eligibility Verification and Advanced Eligibility Verification?
Advanced Eligibility Verification is the initial check done on a patient for their first visit in a calendar year or their first visit after changing insurance. Basic Eligibility Verification is a simplified re-check done for that patient for subsequent visits on the same insurance in the same calendar year where they have already had an Advanced verification. For more information, please see our article on Basic vs. Advanced Eligibility Verification.
What if an insurance company doesn’t have a provider portal?
Most insurance providers today have online portals, and you must provide your practice login to the provider portal if it exists. If you accept an insurance that does not have a provider portal, Adit will still attempt to verify that patient but may do so by phone or other means.
I accept an insurance that isn't listed on the Connect Insurances page. What do I do?
Let your Adit support team know! We will evaluate that insurance and add it to our master list as long as it is a legitimate insurance company.
How do I update my insurance portal login?
You’ll need to make sure you keep your provider portal logins up-to-date in our system to ensure an uninterrupted verification process. If your login for an insurance company’s provider portal changes, you can easily update it so that our team can continue verifying patients with that insurance.
  1. Navigate to the RCM module.
  2. Click Preferences in the top navigation menu.
  3. Select Connect Insurances.
  4. Locate the desired insurance company in the list.
  5. Enter your login for the desired insurance portal:
    1. If you have not entered your login for that portal yet: click the Add button, enter your login, and save.
    2. If you need to edit the existing login, scroll to the right and click the Edit pencil icon, update your login, and save.
Note: If Adit attempts a verification and is unable to access the provider portal because your login is incorrect or invalid, the verification will be placed On Hold.
When do I need to take action on an Insurance Verification?
Adit’s team will handle the majority of your verifications; you will only need to take action on verifications that are Rejected, On Hold, or Failed. You can also verify a patient yourself if you choose to. To learn more about actions you may need to take, please see our article When do I need to take action on an insurance verification?
How do I change which treatment codes are being verified?
You can easily change which treatment codes are verified in either type of eligibility verification. Simply go to the RCM module, click on Preferences in the top navigation menu, then select Verification Settings and scroll down to the section for Advanced Eligibility Verification or Basic Eligibility Verification to modify the treatment codes we verify for either type of verification.

To add a treatment code, select the checkbox next to it in the left panel, and the code will automatically move to the right panel.
To remove a treatment code, click the delete icon next to it in the right panel, and the code will move back to the left panel.

When you have finished making your changes, click the Save button below the treatment code panels.
Can I verify my patients myself?
Yes! Patients that you verify yourself will show a status of Verified followed by the initials of the user who submitted the verification in the Adit platform. If you verify a patient yourself and are unable to complete it, you can also mark a verification as Failed, which will also display with the initials of the user who submitted the failed verification. For more information, please see How To: Manually Verify a Patient’s Insurance.
Will you update the patient file in my PMS/EHR software?
Yes! We can update the patient file in two ways: adding a note, and attaching a PDF.

You can choose to do either or both of these in your preferences in the RCM module. You can also specify the format of the note that is added to the patient file.
How do I check the status of an insurance verification?
Easily check the status of all of your insurance verifications in one place! When you navigate to the RCM module in your Adit platform, it will automatically bring you to the Verifications page. Check the Verification Status column for a color-coded status, and see any pertinent notes in the Details column. For more information about Verification Statuses, please see our article How To: Check the Status of an Insurance Verification.
How am I billed for Insurance Verifications?


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