While looking at the Mission Statement of Healthcare Organizations, it is clear that they come in many sizes and shapes. However, the heart of all those Missions is to provide high-quality, patient-centered care. Yet the intention is straightforward; the act of delivering on the promise is not.
Regardless of size, the facilities, and the in-house team, the Healthcare Organization must balance myriad processes, many of which are not direct patient care. Among prime examples is Revenue Cycle Management.
The reason is that the Revenue Cycle Management Process is directly involved in both Patient Care as well as the Business Side of the Healthcare Organization. RCM processes of Healthcare are not just a single desk task completed by a single team. As per Jordan Shields, a partner at Juniper Advisory, an independent advisory firm that works with hospitals and health systems.
“RCM is an area where a lot of hospitals struggle and the difference between effective Revenue Cycle Management and ineffective Revenue Cycle Management is success or failure in the industry.”
Keeping up with the patient care and RCM Process is hectic and could lead to inaccuracy and revenue leakage. Outsourcing is a valuable way for Healthcare Organizations to streamline administrative processes and enhance revenue. Many Healthcare facilities believe that Outsourced Revenue Cycle Management Services can set them free from the brainstorming process and let them concentrate on their mission, Patient Care.
It’s obvious that there’re significant benefits associated with Medical Billing Outsourcing. The real challenge is finding the best Revenue Cycle Management company. This article clearly explains about Revenue Cycle Management and the steps to find the best RCM Company.
What is Revenue Cycle Management & Outsourcing?
The term Revenue Cycle Management is mainly associated with the Medical Claims by Healthcare Centers and Providers for the service provided by them to the patients. It’s the Financial Process utilizing Medical Billing Software that Healthcare Centers use to track patient care episodes from Registration and Appointment Scheduling to the Final Balance.
The Revenue Management Cycle is crucial to streamlining Administrative Processes for Medical Facilities, particularly Healthcare Centers. Companies that handle Healthcare Outsourcing provide comprehensive Healthcare and Medical Services, including Pre-registration, Appointment Scheduling, Medical Billing, and Coding.
In order to provide a systematic approach that ensures the safety of Patient Records and boosts the efficiency of Clients’ overall operations, these Outsourcing Firms effectively accomplish HIPAA Compliance and receive ISO 27001 and 9001 Certifications.
An ineffective system can cause various unfavorable side effects and negatively impact many different parts of a Medical Organization.
So, How to Select the Best Revenue Cycle Management Company for Your Healthcare?
Well, it’s time to know the steps to choose the best Revenue Cycle Management Company to Outsource. Besides, if you just planned to Outsource RCM Services or if you already Outsource with any RCM Company, read on to know whether your decision is right or wrong. Losing revenue as you work hard shouldn’t be your Healthcare case!
1. Presence of the Revenue Cycle Management Company
The first and foremost step in choosing an RCM Company is to know the age of the Company. Then, ideally, to determine the experience and expertise of the RCM Company. So, what is the time frame to determine the experience? Selecting an RCM Company with five years or above in the industry, would be best. More number of years, more experience, and expertise.
For instance, let’s take our RCM Company, MHRCM, as an example, with ten years in the industry. With our experience and expertise, we have gone through the Regulations and stayed up to date with the Current Healthcare Medical Billing Trends. So, the consistent changes in the Medical Billing Regulations couldn’t cost anything regarding challenges.
2. Check the ISO Certification
Another way to Check the Credibility of the Healthcare RCM Company is to know whether they are ISO 9001 Certified. Why it’s imperative? That is because the Certification is given for the Quality Standards Maintained in the Processes of an Organization.
This is a very crucial aspect that you should look for. The reason is that Medical Claims involve a lot of Processes and Procedures. Since ISO-certified Companies follow Standard Procedures in their work, we can be sure that they have a Structured Process in place.
3. Clients of the Revenue Cycle Management Company
Understanding the Clientele of a Revenue Cycle Management Firm is a crucial consideration too. You must look into the caliber and number of their Customers. The number of Clients they have served is referred to as the Quantity of Clients. The type of Clients served is referred to as the Quality of Clients.
You must comprehend how Clients are distributed in terms of Client Size, Client Kind, and Geographic Location. For instance, if you are a Member of a Group of Doctors that practice in the same Location, search for an RCM Business that has experience with a setup like yours.
You must comprehend how Clients are distributed in terms of Client Size, Client Kind, and Geographic Location. For instance, if you are a Member of a Group of Doctors that practice in the same Location, search for an RCM Business that has experience with a setup like yours.
4. Look for HIPAA Standard
HIPAA, or the Health Insurance Portability and Accountability Act, relates to the Requirements for Safeguarding Patient Data. Why is it crucial? The Security of the Patient’s Personal Medical Information is extremely crucial.
Patients’ Data must be Protected, and this responsibility falls on Hospitals and Doctors. Therefore, confirming that the Revenue Cycle Management Firm you choose complies with HIPAA Regulations is important.
5. Claim Ratio of the RCM Company
Data on an RCM Company’s Number of Accepted and Rejected Claims are hard to come by or get. Generally speaking, most Businesses will be unwilling to disclose their Rejected Claims. Due to a problem on the Patient’s end, some Businesses may even experience an increase in Rejection cases.
Therefore, obtaining this information is challenging. However, we may always inquire about this matter while we are in the conversation or negotiating stage. You can narrow down your choice of candidates, if they are assured and willing to disclose this Data.
This is yet another important aspect to take into account when selecting a Revenue Cycle Management Business. Always be aware of the people that founded the business. Staff in this context refers to the involved Support Team and Top-level Management.
6. The Revenue Cycle Management Team
Understanding their Mission and their Locations are crucial for us. If at all possible, we should be able to learn more about the Team’s Credentials and Experience in this area. This will enable us to determine whether they employ the proper individuals to look after you.
7. The Charges of the RCM Company
Before hiring a Revenue Cycle Management Company, consider this also. The Organization’s Management should always be understood. The Senior Management and the Supporting Team are referred to as “The Team” in this context.
Knowing their Goals and Places on a Geographical Scale is crucial. We ought to be able to learn as much as we can about the Team’s Credentials and Experience in this area. We will be able to determine whether they employ the proper personnel.
8. RCM Company Support Services
The Revenue Cycle Management Company’s Support System is another crucial factor that needs to be examined. We must investigate how their Support System functions. We must make sure the Business is Process-driven rather than Person-driven.
Process-driven Businesses operate autonomously. Person-driven Businesses operate in a way that the work is stopped if the Support Person departs from the Company. Time will be lost while the new individual gets used to the System and this particular scenario. Choosing an RCM Firm with the greatest Support Infrastructure is crucial.
Your Best Revenue Cycle Management Solutions
Possibly, you can get the tenure ideas of choosing the RCM Company. So, we’d like to explain about our Revenue Cycle Management Company, MHRCM. Our Austin RCM Company Provides the Best-in-class Medical Billing and Account Receivable Collections throughout the United States for all Medical, Dental and Therapy Facilities. As mentioned earlier, we possess the Expertise, Certification, and Ability to Streamline your Healthcare RCM Process which includes
Patient Registration
Our Revenue Cycle Management Experts ensure swift and precise Posting of all required Payments, into the medical Billing System. We Consistently Audit Posted Prices to reduce the errors generated in the different types of Medical Processes while Charge-capturing the required information.
Claims Generation & Submission
Our Experts can handle both Electronic Claim Submissions as well as Paper Claims. However, we at MHRCM intend to change Healthcare Centers to shift their focus from Paper to Electronic Claims through our Automation. Still, we can do both for you. We Organize an Explanation Of Benefits (EOB) and submit needed Claims to the Authorized Insurance Company.
Medical Coding
We agree with Timely Restructured Healthcare Standards and Methodologies generated by CMS, AMA, Medicare Contractors, Federal Organizations and Medical Societies.
Payment Posting
Our Revenue Cycle Management Experts ensure swift and precise Posting of all required Payments, into the medical Billing System. We Consistently Audit Posted Prices to reduce the errors generated in the different types of Medical Processes while Charge-capturing the required information.
Denial Management
We also assist in the Analysis, Correction and Re-submission of Denied Claims. This Procedure includes Identifying Denials by the Utilization of Revenue Coding and the Required CPT/HCPCS Codes. At MHRCM, we are trying to shift our focus from Denial Management to Denial Prevention.
Streamlined Cash Flow
Our investment in resources and industry understanding proves to be the perfect Business Partner for many Healthcare Practices. Keep your Healthcare Facility with Streamlined Cash Flow by getting assistance in Multiple Processes. Speak with our Expert and get a Free Demo of our RCM Service.
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