Process

Our Process

From Submission to Final Collection

A structured, analytical, and UAE-focused approach to reduce pending claims and accelerate collections.

Healthcare providers in the UAE submit thousands of claims every month through the eClaim Link portal, yet many claims remain pending, delayed, under-paid, or unaddressed for weeks.

Paramesh RCM brings structure, visibility, and discipline to the follow-up and collections workflow through a clear, data-driven process.

Below is our step-by-step method.

1. Intake & File Review

We begin by understanding your current status.

We collect the core inputs required to activate the tracking and collections workflow:

Monthly claim submission files
Remittance files (EOB/RA)
Aging report (payer-wise)
Rejection summary (if available)
Payer contact matrix

Outcome:

A clear snapshot of your current pending position, aging distribution, and high-impact payers.

2. Data Structuring & Model Setup

We convert raw claim files into a structured FP&A model.

Using our in-house analytics framework:

Submission file and remittance file are merged
Claim status is categorized (Paid / Denied / Pending)
Payer-wise and doctor-wise patterns identified
High-value pending claims highlighted
Date-based timelines imported (DOS, submission, remittance, TAT)

Outcome:

A clean analytical model that reveals what is pending, why it is pending, and where to focus.

3. Building Your Claims Tracker

Your facility receives a custom-built tracker for visibility and daily use.

This tracker includes: :

Payer-wise pending claims
Delay patterns (30, 45, 60+ days)
High-value claim flags
Claims not moving after adjudication
Claims requiring documentation or resubmission

Outcome:

Your team sees exactly what needs attention—no guesswork, no confusion.

4. Follow-Up With TPAs / Payers

Disciplined communication to unlock payments.

Once the tracker is structured, we initiate systematic follow-up:

Bi-monthly emails to each payer
Priority calls for high-value delays
Follow-up on “In Process”, “Pending Docs”, and “Technical Rejects”
Requesting batch status updates
Escalating long-pending items

Outcome:

Payers respond faster, provide clarity, and release many pending cases.

5. Remittance Reconciliation

Matching what you submitted vs. what you received.

We compare:

Billed Amount
Approved Amount
Paid Amount
Deductibles
Shortfalls
Underpayments
Rejections

This identifies:

✔ Missing remittances

✔ Short payments

✔ Wrong tariff applications

✔ Deductibles

✔ System posting issues

Outcome:

Every dirham is accounted for.

6. Exception & Discrepancy Reporting

We highlight all items needing internal or payer correction.

Examples:

System posting mismatches
Claims finalized but not paid
Claims marked “paid” but no remittance uploaded
Claims needing resubmission
Repeated denial reasons

Outcome:

Your billing team receives a clear list of actionable items.

7. Weekly Progress Updates

Simple, clean, and transparent weekly reporting.

Each week, your management receives:

Total pending claims
Movement from last week
New claims finalized
Payments received
Long-pending cases requiring escalation

Outcome:

Management has real-time visibility into cash flow impact.

8. Monthly Executive Dashboard

A complete FP&A-style review of your revenue health.

This includes:

Submitted vs. Remitted vs. Pending
Payer aging and delay trends
Biggest blockers to cash flow
High-value pending claims
Monthly improvement vs. previous months
Operational recommendations

Outcome:

Clear understanding of your facility’s RCM performance and improvements.

9. Closure & Escalation

Final push to close all long-outstanding items.

We escalate:

Aged pending claims
Repeated denials
Non-responsive payers
Short-payments without justification

We also highlight:

Claims to write off
Claims requiring internal correction
Claims requiring payer meetings

Outcome:

A clean, reconciled revenue cycle with reduced pending claims.

⭐ Our Promise: A Clear, Visible, Predictable Claims Cycle

With Paramesh RCM you receive:

Structured tracking
Consistent follow-up
Data-driven decision making
Faster collections
Real-time visibility
Improved cash flow

We work as an extension of your internal billing team, ensuring every claim moves forward—until final payment.

📧 Want to Know How This Process Fits Your Facility?

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