RCM SLAs
Outstanding Accounts Receivable (AR): 95% of claims will have a note associated with them in Athelas Insights within sixty (60) days of the most recent claim submission if not reconciled.
EOB Transcription: 98% of Explanation of Benefits (EOB) documents uploaded by the client will be transcribed within seven (7) days.
Denials: 95% of claim denials under Athelas's responsibility will be worked within twenty-one (21) days of the posted date on the latest claim.
Rejections: 95% of claim rejections under Athelas's responsibility will be worked within fourteen (14) days of the most recent decision.
Eligibility Checks: 95% of all appointments will have all attempted eligibility checks completed by the morning of the appointment when scheduled.
Claims Submissions: 95% of claims will be submitted within twenty-four (24) hours of being closed in the client’s system.
Appeals: 95% of all appeals will be submitted within fourteen (14) days of the appeal initiation.
Payments: Athelas does not guarantee an increase in payments.
Excused Downtime: Any period of unavailability or degraded performance of the Services caused by: (i) scheduled or emergency maintenance, provided Athelas provides reasonable advance notice where practicable; (ii) acts or omissions of Customer or its authorized users, including misconfiguration, unauthorized access attempts, or failure to meet minimum system requirements; (iii) third-party service failures outside Athelas's reasonable control; (iv) Force Majeure events beyond Athelas's reasonable control; (v) Customer's failure to implement configuration changes recommended by Athelas; or (vi) any suspension of Services permitted under the executed Service Agreement.
