Revenue Cycle Management
Cantata Health Solutions offers behavioral health and acute care providers a single and robust Revenue Cycle Management (RCM) solution to help reduce operational expenses while increasing revenue. Unlike traditional “end-to-end” RCM software, Cantata’s provides you with a rich set of capabilities designed to inform, enable, and empower your organization across the revenue cycle.
Simplify the business of healthcare with a platform that:
- Includes Revenue Cycle Management, Financial Management, and Operational Software and services.
- Incorporates Cost Accounting, Materials Management, General Ledger, Predictive Analytics, Claims Processing, and more!
- Seamlessly Integrates and Exchanges EHR Data.
Key Functionality
Cleaner claims, lower A/R days, full visibility, and the analytical foresight to improve outcomes—all from one solution built by experts with deep industry experience to help organizations like yours save time and elevate care.
Client Access
Our RCM software is easily configurable to meet the needs of any healthcare facility or specialty. With RCM, your organization can:
- Accurately collect out-of-pocket and outstanding balances during registration and pre-registration
- Avoid data duplication by giving you ample access to client index information, healthcare eligibility statuses, and a variety of charge captures
- Complete HIPAA audit by field, function, and user
- Integrate with Medicare Secondary Payer (MSP) forms
- And much more!
The solution is extremely flexible, containing nearly 1,000 user-defined fields and can embed 270/271 eligibility transaction sets.
Reporting and Analytics
With complete visibility on your billing operations, RCM Reporting helps your staff comply with changing regulations while preparing new ways to improve your bottom line. This oversight provides real-time access to quality measures, demographics, and funding on a corporate, facility, and client level. Cantata is fully-compatible with other vendors to extract data, and the relational database is easily accessible with various report writers.
Connected Client Data
Increase the interoperability between your RCM and other revenue streams with simple connection tools to achieve a centralized business office (CBO). With RCM Exchange, third party billing data is seamlessly transferred from hospitals, private health centers, and clinics to your RCM, ensuring you are always working with the most up-to-date information to stabilize your finances.
Automated Systems
Help your back-office staff stay efficient with the ability to automate claims, contract management, reimbursement, and account status- based letters, and action rules. Action rules include outsourcing, billing, secondary payer, COBs, late charge processing, etc. Claims are configurable by loop and segment for payer billing and state reporting. We designed our proprietary rules engine with a systematic, yet flexible, method for producing clean claims and timely reimbursements.
Predictive Denials Prevention
When it comes to the details of filing claims, the appeals and recovery process can be the most challenging and costly section. That’s why we take a proactive approach to tracking claim payments with real-time alerts at mid-revenue cycle, triggered follow-ups, and enhanced reporting to prevent denials. Action Rule alerts are configurable and can be automated. These include bad debt rules, small balance write-offs, purging zero balance accounts, etc.
General Ledger Routing
General Ledger Routing provides the ability to track and manage financial data, including income and expenses, across an organization’s entire financial cycle. This feature helps businesses process payments more efficiently, improve employee productivity and streamline operations. Payments, Adjustments, charges, refunds are all integrated into the General Ledger, eliminating the need for manual entry into each and ensuring accuracy across all financial records.
Revenue Cycle Advisory Services
Our Revenue Cycle advisors help through the revenue cycle continuum by optimizing processes and workflows, accelerating reimbursement time, and providing strategic avenues for revenue growth. With a dedicated Implementation Project Manager and 24/7 access to your personal Support Team, you can rest assured that we are available to lend a hand, day, or night. Learn more by heading to our Managed IT Services page.
Frequently Asked Questions
Optimum RCM is Cantata’s revenue cycle solution for acute care organizations. Arize includes integrated billing capabilities designed for behavioral health and human services providers, connecting payer information, services, clinical documentation, claims and reporting within the broader Arize platform.
Because billing is integrated with the Arize EHR, the system can use client, payer, service and clinical documentation data throughout the billing process. Configurable validations can check for required information—such as a diagnosis or treatment plan—before a claim is generated. This helps keep clinical and financial workflows aligned while reducing duplicate entry and follow-up work.
Arize supports client payer setup, real-time eligibility checks, payer and service configuration, rate management, split billing, claims generation and complex payer sequencing. It also supports specialized workflows such as CCBHC bundled billing and conditional billing logic. Billing data can be exported for analysis, sent to clearinghouses using 837 and 835 files, and formatted for import into general ledger systems.
Arize includes an error manager with configurable billing validations. Organizations can determine which issues should generate a warning and which should create a hard stop, preventing a claim from being produced until required information is corrected. Validations can check elements such as diagnoses, treatment plans and other documentation or billing requirements.
Yes. Organizations can establish each client’s payer order, configure sliding-fee scales and assign coverage at the service level. When a primary payer does not cover a service, Arize can move it to the next applicable payer in the client’s sequence. The system also supports splitting a service between multiple payers and managing CCBHC scenarios involving bundled services, conditional billing, and commercial and secondary coverage.
Yes. While Arize is our flagship behavioral health EHR, Optimum, our Revenue Cycle Management and General Financials solution, is built for acute, post-acute, rehabilitations, and psychiatric care. Optimum helps these facilities increase revenue and cash flow, reduce AR days, improve operations, and enhance the revenue cycle process.