Do you know that Revenue Cycle Management is one of the important business functions for many healthcare providers?
Revenue Cycle Management directly affects the patient and their experience. Regardless of how many claims a billing team submits, the Medical Revenue Cycle Management Process must be straightforward from the very beginning. In this blog, MHRCM provides various strategies for healthcare providers to improve RCM services.
Check Payment Procedures Initially
This is closely related to verifying the eligibility of the patient. During a patient’s appointment, your staff should promptly obtain current information from them, including insurance and payment method verification. The patient should be able to enter this information as part of the procedure if they self-schedule using your portal.
Since online payment methods are beneficial and well-known to patients, it is a good idea for experts to offer this option in order to encourage timely payments. Generally speaking, your patients will respond better if your payment method is easier to use and more accessible.
Improve the Claims Procedure
The process of making sure a claim is complete, accurate, and correct before sending it to an insurer is known as claims scrubbing. This task works well for automation. This simple approach helps to increase the likelihood of getting paid on time.
Scrubbing used to be a laborious physical task that took a long time, but with the advancement of software, it can now be done almost instantly. Your business should never submit a claim that hasn’t been approved by your internal center, for any reason at all.
Outsource Medical Billing
Of course, giving your medical billing procedures to a specialist is one of the simplest methods to improve them. Partnering together with a revenue manager is simple, effective, and takes all the revenue-related burden away from you.
In order to collect more charges and accelerate payment to you, your Revenue Cycle Manager will seek to enhance the efficiency of your processes. Consulting with an expert is always a good idea when looking for methods to improve.
Claim Denial Management
Although denied claims are inevitable, they can be reduced with meticulous preparation and close attention to detail. For instance, you can achieve a 99% first-pass acceptance rate by choosing experts to manage your Revenue Cycle Management Process. That’s undoubtedly a great benchmark for working toward whatever the Healthcare Revenue Cycle Management Strategy you decide on.
It’s crucial to investigate claims that are rejected. Medical offices lose out on revenue because a lot of rejected claims disappear in the process and are never resubmitted. A Priority Management System that can automatically identify denied requests and mark them for further review. In addition, this helps to prevent major delays to your Revenue Cycle.
Monitor and Investigate Claims
Not all denied claims need to be followed up on. Ensure that your team follows a procedure when contacting patients who are behind on their payments. Have a plan set up for following up with patients who aren’t paying on time.
Give these patients options: should they arrange a payment schedule, settle the balance in full, or find another way to make ends meet? By allowing for this kind of flexibility, you can make the money possible from these circumstances.
Workflow Automation
Use an insurance discovery tool to identify all active payers simultaneously. This eliminates the need to contact each payer individually to automate patient access. Workflow rules include assigning claims to a single biller. This helps to assign an organized set of claims for every person to concentrate on. Let technology handle the creation of templated patient statements and sending of invoices by email. This facilitates effective patient payment collections.
Automation can be done in a lot of ways during the Revenue Cycle. Most billing teams need to determine which areas of their RCM workflows are most benefiting from technology.
Simplify Patient Access
Verifying patient demographics, such as first and last name, current address, and Social Security Number, is an efficient aspect of patient access. It’s also beneficial for providers to verify any additional coverage beyond what the patient has supplied. Patients frequently have secondary coverage that they have not declared or are unaware of. With the correct software, managing all aspects of patient access is simple. You can record patient data, confirm coverage and demographics, and prevent any future revenue cycle errors.
Enhance Revenue Cycle Management with KPIs
Assessing Key Performance Indicators (KPIs) is the only approach that can accurately determine how well your Medical Revenue Cycle Management is working.
- Total amount reimbursed
- Ratio of net collections
- The duration of claims in accounts receivable
- Acceptance rate for first attempts
- Denial rate
It will be much simpler to track your success as you try to optimize your Medical Revenue Cycle with an analytics tool that allows you to keep track on all of these metrics.
Recognize Payer Rules
In regard to possible errors in the Revenue Cycle, let us analyze payer regulations. There are differences among commercial payers, Medicare, and Medicaid in terms of how to submit claims and what codes to utilize. Furthermore, those guidelines are subject to alteration at any time.
However, it is much simpler to make sure that every claim is being sent to the correct payer if you have access to a claim’s submission tool. This is done for you with the RCM Software.
Staff Engagement and Training
Each employee in the front office and back office has a crucial part to play in enhancing RCM procedures, and they should be aware of this. Staff Engagement starts with clearly defining each employee’s values and providing them with the resources they require to be successful.
Provide plenty of chances for training and understanding with the modified processes for each new automated workflow. Provide ongoing training regularly to support the maintenance of established procedures. This also presents excellent chances for additional innovation. Furthermore, assign training as the top priority to all new billers, office managers, team administrators, and other individuals involved with the claim lifecycle. The more that a team is engaged, the more you are powered to succeed.
Focus on Patient Care
Finally, it’s essential to keep in mind that the patient always comes first, even when managing the Revenue Healthcare Cycle.
Offer potential patients the choice to submit their information by themselves rather than submitting it through a patient portal. This saves time and enables them to submit the information on their own schedule.
Why is Revenue Cycle Management Significant?
Raising provider income is the aim of Healthcare Revenue Cycle. Since RCM enables healthcare companies to continue operating and treat more patients, it is a crucial strategy that they should use. Nevertheless, RCM benefits more than just providers. Providers may allocate more funds and resources to patient care when they generate more revenue.
Healthcare Revenue Cycle Management ensures that patient data and coding on submitted claims are accurate, which not only increases revenue but also reduces the possibility of insurance refused claims. Providers save money by not having to look into denials, dispute them and find the right codes when claims are accepted.
Transforming Your Revenue Cycle from Beginning to End
It is less important to completely transform your RCM workflow. However, it is significant to determine which aspect of the revenue cycle to prioritize.
The Revenue Cycle Management Solutions such as confirming the patient’s eligibility and demographics, preparing a claim using the correct codes, and submitting it to the relevant payer never change. However, those stages offer an abundance of chances to develop optimized and more effective procedures. Automating Workflows, providing more resources and training for employees helps to improve Revenue Cycle Management Services in an effective way.
Conclusion
MHRCM has given a lot of information about managing an effective Revenue Cycle. A long-term partnership is always the outcome of a clear payer/provider relationship. Inform them of the potential costs associated with starting their treatment early on. Patients will focus more on patient care. Furthermore, this approach to payments will aid healthcare providers to achieve their payments. For clear understanding you can visit the blog.
Frequently Asked Questions
What Is the Best Practice in Revenue Cycle Management?
An effective Revenue Cycle Management Services includes certain practices such as obtaining payment information initially, enhancing claim filing speed, managing claim denials and tracking balances in Accounts Receivables (AR) payment.
How Can a Company Enhance Its Revenue Cycle Management?
A company can enhance its Revenue Cycle Management by including workflow automation, ensuring how many denials you have, combining RCM, set goals and monitor KPI metrics.
What is Meant by Patient Access?
Patient Access refers to procedures that help patients access and navigate the healthcare system. These services include scheduling appointments, services registration, obtaining insuring coverage and more.
Why is Revenue Cycle Management Important?
The goal of Revenue Cycle Management is to improve provider revenue. RCM is considered an effective strategy for healthcare companies to provide treatment for more patients. With increased revenue, providers can spend more time and money on patient care.
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