Improve Patient Care
with Smarter Revenue
Cycle Integrity

As a value-based healthcare provider, your focus must be on patient satisfaction. We help you do that by bringing accuracy and efficiency to your managed care operations.

A trusted partner to
over 250 healthcare
professionals

HOM (Healthcare Operations Management) offers an array of revenue
cycle management services to physicians, general practitioners,
group practices and nurse practitioners.

HOM strives to create a transparent culture where people feel
empowered, recognize core competence and excel in what they do
the best. A leading advisory and development organization, it offers
cutting-edge technology-based solutions to clients.
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Demographic Entry

Collection of patient information and consent required for the medical record in order to meet established clinical, financial and regulatory demands.

Eligibility Verification

Validating patient’s eligibility and benefits to ensure provider receives payment for services rendered.

Prior Authorization

Procedure of obtaining prior approval from the payer(insurance company) before the healthcare provider offers services to the patient.

Coding

Identification of medical diagnoses and procedures and documenting them in a patient’s medical record as universally accepted codes.

Billing and Charge Posting

Recording information about the services provided into a medical claim for billing.

Claim Management

Determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.

Utilization Management

Recording information about the services provided into a medical claim for billing.

RAPS/ EDPS

Determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.

CDI/Chart Prep

Ensuring that the events of the patient encounter are captured accurately, and the electronic health records properly reflects the services that were provided.

Credentialing

Recording information about the services provided into a medical claim for billing.

Referral Management

Referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring source believes is necessary but is not prepared or qualified to provide.

Quality (HEDIS)

HEDIS® is a set of standardized performance measures developed by the NCQA to objectively measure, report, and compare quality across health plans.

Payment/ ERA posting

Reconciling the payments received from the insurance payer to each individual claim. Once payments are posted, any secondary claims can be created and submitted.

Denial/ AR Management

Tracking and managing unpaid claims ensuring that no time is lost on pursuing every reimbursement possibility.

Pre Visit

Transforming healthcare operations with our services

  • Demographic Entry

    Collection of patient information and consent required for the medical record in order to meet established clinical, financial and regulatory demands.

  • Eligibility Verification

    Validating patient’s eligibility and benefits to ensure provider receives payment for services rendered.

  • Prior Authorization

    Procedure of obtaining prior approval from the payer(insurance company) before the healthcare provider offers services to the patient.

  • Medical Coding

    Identification of medical diagnoses and procedures and documenting them in a patient’s medical record as universally accepted codes.

  • Billing and Charge Posting

    Recording information about the services provided into a medical claim for billing.

  • Claim Management

    Determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.

  • Utilization Management

    Recording information about the services provided into a medical claim for billing.

  • RAPS/ EDPS

    Determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.

  • CDI/Chart Prep

    IEnsuring that the events of the patient encounter are captured accurately, and the electronic health records properly reflects the services that were provided.

  • Credentialing

    Recording information about the services provided into a medical claim for billing.

  • Referral Management

    Referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring source believes is necessary but is not prepared or qualified to provide.

  • Quality (HEDIS)

    HEDIS® is a set of standardized performance measures developed by the NCQA to objectively measure, report, and compare quality across health plans.

  • Payment/ ERA posting

    Reconciling the payments received from the insurance payer to each individual claim. Once payments are posted, any secondary claims can be created and submitted.

  • Denial/ AR Management

    Tracking and managing unpaid claims ensuring that no time is lost on pursuing every reimbursement possibility.

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With decades of collective experience and deep knowledge of Healthcare Operations, our solutions are high-quality and cost-effective.