Revenue cycle management is the strategy that healthcare providers use to manage financial reimbursements in their revenue cycle. These are reimbursements concerning administrative and clinical functions within the revenue cycles. In healthcare, the revenue cycle begins when a patient contacts a healthcare provider for an appointment and ends with the complete collection of all payments for the appointment and treatment.
Identifying and resolving points of friction in a provider’s revenue cycle is the goal of revenue cycle management. Correctly applying revenue cycle management in healthcare helps providers maximize their claim reimbursements and increase their revenue. It also ensures healthcare providers with quick and proper reimbursements for their services.
A good example highlighting the benefits of RCM is the great degree of transparency that it enables between healthcare providers and their patients. The possibility of such transparency makes for good customer satisfaction which increases brand loyalty and improves revenue collection. For example, when healthcare providers enable RCM, they can inform their patients of payments that they might need to pay out of their own pockets. This lets the patients plan their treatments and payments around this information, thus creating a much more satisfying experience overall.
Ways to Optimize Healthcare Revenue Cycle Management
The healthcare revenue cycle has multiple steps from the beginning to the end, and because of this, errors at any initial stage significantly increase the chances of errors committed overall. These errors may lead to delays in claims processing or bring it to a halt altogether, thus costing healthcare providers their necessary reimbursements. Here are some ways healthcare providers can optimize their revenue cycle management:
Optimal Workforce Collaboration
Since RCM needs all formalities to be accurately processed at every stage, there is an essential need for flawless collaboration between the staff involved in all the different stages. Maintaining a well-collaborated staff throughout the claims process significantly reduces the chances of errors occurring at any stage as they can be identified immediately. Thus, ensuring the smooth processing of the revenue cycle and reduction in denied claims at the end of the process. All these benefits strongly iterate the need for having a staff that works closely with pros largely outweighing any cons if they are there.
Implementing Regular Internal Audits
Implementation of revenue cycle management helps providers identify the errors as they occur when claims are processed. This is possible because RCM implements regular checks at every stage as a part of the claims process. Thus, the success rate of processed claims increases significantly as most of these issues become easily preventable.
Regular internal audits are a great way to analyze repeated errors in a cycle and reduce them accordingly. Claim denials become more manageable by implementing these checkpoints at each level.
Efficient Charge Capturing And Coding
The process in which patient services are transcribed into billable charges using universally accepted medical codes is called charge capturing. These codes are how insurers determine reimbursement amounts.
Improper medical coding may lead to the denial of a patient’s claim by the insurance company. It leads to delays in proper reimbursements, costing time and money for the providers in investigations and appeals. Accuracy in coding is very important so that denials can be avoided altogether.
Having An Experienced Debt Collecting Partner
Revenue cycle management requires expertise and experience to attain positive results on claims submission. It can prove to be quite taxing as finding and retaining experienced staff is challenging and not the core business of the healthcare provider. Therefore, outsourcing some of these processes of revenue cycle management to an EBO provider or debt collection company that is well equipped and experienced in dealing with them is a wise choice. Doing so allows healthcare providers to run their businesses smoothly without stressing about claims denials while focusing more on customer satisfaction.
First Credit Services is a debt collection agency that has more than 25+ years of experience in the industry. We have helped our clients with claims processing and bad debts effectively which has ensured smooth running and continued benefit of their business operations. Our Extended Business Office (EBO) service assists our clients in the healthcare industry with recovering insurance balances, resolving denied claims, and executing appeals and claims. With us, healthcare providers can take care of their patients without any worries, because FCS can take care of their unpaid accounts.
Revenue cycle management increases the revenue of healthcare providers while decreasing the time they spend on administrative and clinical functions for claims. A good revenue cycle management process will translate to shorter AR days, fewer delinquent patients, and higher reimbursement rates.
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