Rita Chaudhury, Founder & Director, ELATE Revenue Cycle Management Services Pvt Ltd

While healthcare facilities of all kinds are known for saving lives and treating patients, they also need to have successful policies and processes in place to stay financially afloat, and that’s where revenue cycle management (RCM) comes in. In today’s complex and fast-evolving healthcare industry, RCM is about much more than billing and collecting payment. As the healthcare industry grows, conventional, time-consuming approaches to managing the revenue cycle require too many resources and leave unacceptably broad margins for error. Thus, the modern healthcare landscape calls for a comprehensive, standardized, and data-driven revenue cycle management process.

Realizing this need of the hour, Rita Chaudhury, an industry veteran with a demonstrated history of working in the hospital & health care industry laid the foundation of ELATE Revenue Cycle Management Services Pvt Ltd in 2015. Under the insightful leadership of Rita, ELATE is redefining traditional operating models and transforming processes to create extraordinary value in Medical Claim Management. Supported by the rich domain expertise of 30+ years of experience and robust technology, the company is providing end-to-end revenue cycle solutions to organizations in the Healthcare industry, such as hospitals, midsized provider organizations, and Medical Billing Companies in the US. “We provide backend service on a 24×5 Model. We focus on providing timely and errorless end-to-end revenue cycle solutions to our clients. Every solution we create responds to the client’s unique need and is designed to deliver sustainable value,” opines Rita.

A Seasoned Leader with a Strong Background

As a person with a deep commitment to excellence, Rita ideated ELATE with more than 20 years of experience in the USA healthcare industry and extensive operational and financial expertise. She is six sigma Black Belt Certified as well as HIPAA, Medical Compliance, and Coding certified through global institutions like Anexus Denmark, American Academy of Professional Coders (AAPC), and American Health Information Management Association (AHIMA), USA. “While I was working as an employee in other corporate, I could learn a lot regarding the nitty-gritty of these Industries in terms of Operations, Business management, Resource management, Quality Compliance, Client perspective and expectation, Business strategy, etc. I could create a good network and a reputation regarding my work with the authorized people of this Industry in the United States of America. This was the major thing that helped me to take the challenge to incept my own company, ELATE,” affirms Rita.

Providing End-To-End Revenue Cycle Execution for Providers

ELATE is one of the pioneers in offshore outsourcing services like medical coding, patient registration/demographic entry, insurance eligibility verification, payment posting, accounts receivable management, denial management, down-coding analysis, report generation, and clinical documentation analysis and improvement. ELATE has a proven track record of successfully maintaining very high standards in providing patient information management services to hospitals at its offshore facilities through a robust framework. Today, it serves the 10 Large Hospitals in 7 Locations in the USA, and more than 350 doctors and physician assistants of these hospitals are availing its services on RCM. “We are 7+ years old business and our service quality, qualified professionals, our commitment to our client, turn-around time (TAT) for service delivery and charges are competitive which keeps ELATE’s head high,” asserts Rita.

Giving Client’s Privacy and Security the Highest Priority

ELATE RCM is HIPAA and ISO 9001:2015 Compliant Organization. It takes compliances very seriously; It has undertaken various steps and designed its process to ensure the same. Client privacy and security are given the highest priority at ELATE. Thus, all of its clients’ office records are kept behind a secure firewall and all electronic claims are securely encrypted for transmission. The company uses Virtual Private Network (VPN) that secures the private network using encryption and other secured mechanisms to ensure that only authorized users can access the network and that the data cannot be intercepted. This type of network is designed to provide a secure, encrypted tunnel to transmit the data between the remote user and the private, corporate network.

Standing Tall For Its Clients during the Difficult Time

During the COVID-19 Global Pandemic, when the hospitals and physicians were struggling to keep their heads above water with a lack of test kits, limited healthcare professionals vs. an increasing number of Covid patients per day, and the new compliance rules for billing their services, ELATE stood tall for its clients during this challenging time. Each employee of ELATE was available 24X7 for any type of backup supports on coding, billing, and compliance issue. As new medical codes and billing compliance rules were constantly getting introduced for the COVID19 services by the CMS, its certified medical coders were constantly educating themselves regarding the new compliance rules on Coding/Billing/Telehealth/Tele medicine before the submission of each claim with accuracy. Meanwhile, ELATE Accounts receivable team was also handling the denied claims for faster and timely payment. ELATE designed its services in a manner that all deficient documentation can be addressed by the coders and then clarified and verified by the providers for the sake of documentation compliance, reimbursement boost and to control the denial rates. “Since we believe in ‘denial prevention is better than management’, we proactively arrange for the onsite meeting on the CDI (clinical documentation improvement) with the providers (MD) and physician assistants (PA) to discuss the reimbursement pitfalls due to documentation deficiencies in EMR, what are the new COVID19 coding/billing/compliance regulations and protocol, so that there is no payment gap and time constraints,” states Rita.

Addressing the Key Challenges in Healthcare

According to Rita, despite the growth in EHR technology and adoption in healthcare, the data silos make interoperability a significant challenge. Additionally, these EHR systems are designed for “one size fits all” whereas humans and medicines are all different with constantly changing needs. Thus, she believes that EHRs must be able to share data among the many different hospitals, offices, and other facilities following the HIPAA and HITECH Act where individuals seek care—especially when healthcare providers are seeing new patients and need to obtain information from previous care providers. “Health information is ONLY good when it is SHARED to enhance the overall positive outcome of the patient,” she adds.

Another key challenge that Rita aspires to address is the severe shortage of healthcare professionals. The healthcare system around the world is under enormous pressure as there is a severe shortage of healthcare professionals, which could reach 10 million by 2030, and this has been worst by COVID19. The avid leader thus aspires to bridge the gap through ELATE and plans to touch the lives of 2000 youths by 2025, by developing their skills in Medical Coding/Billing/Compliance/Auditing/Risk Management while enhancing their employability in Healthcare Industry.

Continues Shaping the Future of Healthcare

Looking at the future, Rita believes that the healthcare system will see a massive change in the field of preventative medicine with the help of Artificial Intelligence in the coming years. She also sees data as the foundation for the future of healthcare operations. Thus, at ELATE, she is focusing on ensuring accurate data for the future, which starts with highly effective clinical documentation improvement (CDI) programs with the implementation of AI and Blockchain. “CDI is highly required in every step of the claim management cycle with optimum privacy and security. Without effective, efficient data collection and recording, there is no guarantee that patient data is accurate. This not only presents a roadblock to creating a more data-driven future of medicine but is also challenging for healthcare organizations today,” elucidates Rita. “Your Brand Reputation Depends on Accurate Data. It’s imperative to create a culture within the organization to be focused on critical thinking that empowers both staff and clinicians to be strategic in their documentation,” she adds on a concluding note.