Rubixis
Relentless Pursuit of RCM Perfection

One of the most important functions of a healthcare provider, outside of providing healthcare, is to effectively bill and collect money due from insurance payers. Unfortunately, this area has opaque processes, antiquated technologies, and confusing regulations. Into this status, enter Rubixis. With the aim to solve the complexities in healthcare, the Fremont, CA- based firm is a combination of cross-functional, across-industry expertise, and has an innovative analytical platform. “We ought to be able to solve challenges within Revenue Cycle Management (RCM) in a systemic manner by intelligently integrating data present in disparate systems,” states Manoj Sharma, CEO, Rubixis. It is extremely important for a healthcare institution to know the gaps in their revenue cycle processes and has grown increasingly challenging for healthcare providers because the average reimbursement on claims is on a downward trend due to increase in Medicaid and Managed Medicaid payer mix, and high deductible plans. “Our approach is to optimize each stage in the revenue cycle process such that all the money comes in as fast as possible, and the process doesn’t incur high costs,” adds Sharma.

Rubixis’ Solution is built on the premise that there are mathematically optimal answers to peak revenue, minimum A/R days, and lowest costs and a scientific basis for approaching these optima. The firm’s fully integrated comprehensive RCM solution provides a workflow driven approach that ensures healthcare providers capture 100 percent of money from insurance payers.

Rubixis’ comprehensive solution incorporates various technologies and automation tools and complements them with manual resources to achieve a zero-defect solution with complete coverage. By operating in partnership with their clients, the firm’s goal is to enable an organization’s business office to operate at peak revenue potential.

Our flagship product is really an integrated revenue cycle platform, which is not focused on providing point software solutions but on the end goal of optimizing each stage of Revenue Cycle

“Our flagship product is really an integrated revenue cycle platform, which is not focused on providing point software solutions but on the end goal of optimizing each stage of Revenue Cycle so our clients can achieve and maintain peak revenue potential,” mentions Sharma. With their innovative solution portfolio, Rubixis enables organizations to augment their ROI by maximizing reimbursement, reduce A/R days, and trim down process costs. “One of our clients was able to take their cash to net revenue from 90 percent to 105 percent in first 90 days as Rubixis’ integrated system and associated analytical dashboards was able to immediately identify prioritized list of projects that client needed to execute to accelerate cash collection,” recalls Sharma.

Another component of the firm’s broad solution assortment is the “Payer Scorecard”. “Optimization of our client’s Revenue Cycle means that Payers need to be held accountable when they are not holding their end of the bargain,” says Sharma.

The firm is driven by innovation and cross-functional expertise, and is now pushing the envelope to incorporate all new trends into their business model. “As an example a lot of our clients currently may have only 5-10 percent of their revenue cycle on risk sharing agreements with Payers, while 90-95 percent is traditional fee for service. However, our clients are increasingly migrating towards these new reimbursement models, and our solution is evolving with them to ensure our clients have seamless transition to blended reimbursement models,” explains Sharma. “The elections outcome will influence people’s insurance coverage and correspondingly the healthcare landscape. And I think technology is a great enabler to deal with all these complex challenges. I frankly think as a software vendor which embraces uncertainty and complexity, there are pretty exciting times ahead of us,” concludes Sharma.