Revenue Cycle Management (RCM) & Medical Billing Software Solutions

Chetu Partners HBMA

RCM Software Development Solutions

  • Custom medical Revenue Cycle Management (RCM) software development for insurance eligibility verification (including batching capabilities), prior authorization and referrals, claims (including status, tracking, denials, overpayments, and appeals), attachments (including HL7 Consolidated Document Architecture, PDF, and others), remittance advice, health plan payment processing, and coordination of benefits
  • We engineer patient insurance validation software with custom integration services to 3rd parties such as ezVerify and RelayClearance
  • Development of automated medical billing software, integrated with processing systems for collection of copays, deductibles, and coinsurance payments at the point-of-care
  • We integrate RCM software with Practice Management Systems (PMS) and Electronic Health Records (EHRs) for automating creation of charge sheets with the appropriate International Classification of Diseases-10 (ICD-10) and Current Procedural Terminology (CPT) to submit claims
  • We develop claim scrubbing software for detecting data entry errors and rules engine analyzing for compliance with specific insurance carrier requirements
  • We facilitate real-time electronic claims and submissions (including CMS-1500 Professional Paper Claim Form) to primary / secondary / tertiary payers, Medicare, and Medicaid
  • Programing of provider-facing Service Oriented Architecture (SOA) / web service engine and portals with integrated EMRs / EHRs for sending claims
  • Integration with billing and claims platforms using Electronic Data Interchange (EDI) transaction sets including 270/271 (eligibility / benefit inquiry & response), 835/837 (health care claim & health care claim payment), 834 (benefit enrollment & maintenance), and 276/277 (health care claim status request & health care information status notification)
  • E-claims National Council for Prescription Drug Programs (NCPDP D.0 & 5010) technology solutions to ensure the consistency of distribution and billing of pharmaceuticals
  • We engineer claim validation software and custom integration services with 3rd party clearing houses including Availity and Emdeon
  • Programming of claim status tracking functions including tracking claims, submission, claims processing, claim acceptance, and automated follow up for claim denials
  • We facilitate account reconciliation processing with patients via online billing portal development
  • Custom payment gateway integration to support authorization, capture, sale, void, partial reversal, refund, recurring, and other payment types with credit, debit, and prepaid/gift cards

We Ensure your Compliance with Meaningful Use & HIPAA

Chetu's healthcare software development experts ensures your software complies with regulatory standards including specifications set by the U.S. Department of Health and Human Services (HHS), Office of the National Coordinator – Authorized Testing and Certification Body (ONC-ATCB), HITECH's Meaningful Use Stage 1 and 2 (MU-1 & MU-2), Health Insurance Portability and Accountability Act (HIPAA), and Health Level 7 International (HL7).

Our Healthcare Software Development Solutions

Want to Know More?

Chetu is the premier provider of custom RCM software development solutions for businesses worldwide. Consult our software solutions specialists now to discuss how our software development services will help you overcome your healthcare technology challenges.

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