NNews March 2024

23 March 2024 As Chief Business Officer at Legacy Treatment Services, Nick DeRose, alongwith his team, engaged in a series of collaborations with various third-party billing entities and uncovered challenges and shortcomings of existing recovery cycle management (RCM) services in the industry. The turning point came when they identified a strong connectionwith Apex Healthcare Strategies and acknowledged the pressing need for a more robust model to address the significant gaps within the behavioral healthcare system. “Apex understands the complexities we face in the behavioral healthcare system. They helped Legacy manage frequent regulatory changes in our ever-changing industry. We had an a-ha moment and asked, ‘Why don’t we do this ourselves?’ So, we workedwith Apex during the pandemic to create Integrated RCMServices (IRCMS),” said DeRose, who is now CEO of IRCMS and recently joined NJAMHAA’s IntegratedHealthcare Council. Integrated RCM Services Helps Providers Maximize Revenue and Focus More on Serving Patients IRCMS was established in June 2023 and launched in September 2023. In addition to Legacy, clients include hospitals, federally qualified health centers, other primary care facilities and private providers in New Jersey and across the nation. “We understand each organization’s challenges and structure services to address those specific needs,” said Jamie Knox, COO. She cited front desk issues as examples of situations IRCMS assists with, as well as difficulties obtaining and verifying the necessary demographics and insurance information, securing authorizations correctly, and more. “We hear frommany organizations that they don’t have confidence in their own numbers, regardless of practice size. We customize a solution that fits within each organization’s infrastructure,” DeRose said. He stated that many IRCMS clients have small teams withmultifaceted responsibilities who are not necessarily trained inmedical billing. “For example, someone responsible for billing may also bemanaging other fiscal responsibilities such as accounts payable andmay not knowbest practices or how to navigate common complex challenges,” he noted. IRCMS offers a comprehensive suite of services, including patient data management, eligibility verification, meticulous coding and compliance audits, complete billing process management, payment posting, proactive accounts receivable follow-up, denial appeals, addressing outstanding “ We’re an extension of each client’s team, filling the gaps created when staff is stretched too thin. We provide support in every possible way we can. ” Jamie Knox COO (continued on page 24)