Management of the revenue cycle is crucial to running a successful medical practice. One benefit is the direct financial impact on the provider. RCM, or revenue cycle management, is more significant because it has an immediate impact on the patient and their experience. Medical Billing Services in California should have a thorough understanding of strategies for revenue cycle management and search for methods to enhance it in order to get the most out of it and stay current with changes and trends in the healthcare business.
So how can a medical billing company manage its revenue cycle better?
There are various ways a provider can enhance their strategies for revenue cycle management in light of evolving technology and patient preferences, as doing so will enhance both their financial situation and the standard of their patient care. Let’s start now.
What Is the Importance of Revenue Cycle Management?
Increasing medical billing businesses’ income is the objective of strategies for revenue cycle management. Given that it enables them to continue operating and treating more patients, RCM is a crucial approach for healthcare providers to employ. However, revenue cycle management has advantages that extend beyond only the providers. Increased revenue enables clinicians to devote more resources and time to patient care.
RCM makes sure that patient data and coding are accurate on submitted claims, which not only boosts income but also lowers the possibility of insurance claims being denied. Providers save time and money by not having to investigate refused claims and file an appeal. Administrative staff can now spend more time with the patient as a result.
There are numerous milestones in the revenue cycle, and each one is essential to ensuring fast provider reimbursement. Account creation, pre-registration, insurance eligibility verification, and medical coding are examples of tasks that take more time to execute because they demand precision.
However, these activities also require a swift in order to get paid right away. Because of this, service providers must improve where they can. An automated workflow system is one beneficial development.
Automating Workflows in Practice
Systems for automating workflows are a great resource for strategies for revenue cycle management. They are utilized to:
- Put your attention on front-end chores to forward claims fast.
- When necessary, migrate patient files and create non-patient files.
- Check and update patient information proactively.
- Automatically add comments with codes
- Verify insurance details before the patient visit
- Before a meeting, update any policies that are out of date or missing.
One of the most significant enhancements providers can make to their RCM is the implementation of workflow automation. Why?
Front-end duties must be accurate, therefore mistakes can easily happen in the early stages of RCM and lead to a claim being rejected. The majority of mistakes are caused by things like incomplete or incorrect patient information and coding. Approximately 90% of claim denials are entirely avoidable.
Workflow automation systems reduce the possibility of claim denials by guaranteeing the accuracy of patient and claim information. The provider gains from this in two ways:
1. Increasing sales
Providers are not paid for the services they rendered when claims are denied. Providers lose money if a claim is rejected because they execute services before submitting claims.
The cost for providers to look into and contest a claim denial is roughly $15,000.
2 Therefore, the provider has already suffered a loss of income even if they successfully appeal the claim denial and submit a new one. Because of this, successful claim denial prevention can increase a hospital’s income by more than $5 million3.
2. Extension of time
It takes time to look into and appeal a claim denial. It diverts administrative workers from their typical responsibilities. Administrative employees can spend more time on patient care by preventing claim denials in the first place.
Implementing automated workflow solutions for front-end chores is actually more cost-effective than manually carrying out these operations, in addition to saving money by eliminating denied claims.
For instance, manually verifying prior authorizations and eligibility costs providers $7.50 on average per transaction.
4 However, providers only pay $1.89 for each transaction when using electronic prior authorizations. Despite the fact that providers may have to pay upfront or these automated systems, the systems themselves will more than cover the expense.
Investing in Employees
A healthcare center can invest in other things besides technology. Investing in administrative employees is equally crucial. Front-end duties are frequently assigned to certain administrative personnel, whilst back-end duties, including revenue collection, are assigned to other departments.
Employee education programs can educate workers in all facets of RCM so that they are more knowledgeable about the entire revenue cycle as opposed to just their particular aspect of it. This makes it simpler for administrative personnel to comprehend how they might collaborate to ensure a smooth and effective transfer from front-end tasks to back-end tasks.
Knowledge of Patient Preferences
The most crucial aspect of managing medical practice is the patients. Since there won’t be any patients, providers won’t see an increase in revenue.
Treatment is only one aspect of providing high-quality patient care. The goal is to give patients a positive experience in which they feel heard, recognized, and helped through what could be a very difficult moment in their lives. Healthcare and insurance can be scary and perplexing for many patients. The patient experience should be as stress-free as possible for the providers.
Streamlining patient duties is one of the best methods to raise patient happiness. Patients may find it simpler thanks to automated workflows to:
- Make appointments.
- Get emails and SMS reminding you of appointments and payments.
- Online bill payment
- Set up recurring payments
- Utilize web platforms to gain access to medical and financial information
These automated technologies are in fact more patient-friendly. These technologies are not only easy to use and provide patients a sense of greater involvement in their healthcare. With automated mechanisms in place, communication between administrative personnel and patients is no longer time-consuming and complex.
A healthcare facility may be sure those patients will return the next time they require medical attention by improving the patient experience. Higher profitability for the provider results from this.
Simply said, helping the patient benefits everyone.
Getting Advance Payments
In addition to patient choice, establishing an automated workflow system will guarantee that the payments are in time. Healthcare revenue collection cycles get slow of late and underpaid patients’ financial responsibility. In order to help patients better grasp their financial obligations, doctors can offer them financial projections using an automated workflow system.
Providers can also enhance RCM by requiring upfront payment from patients. Automated systems can be used to implement point-of-service or pre-payment alternatives, allowing patients to conveniently pay for services before they are provided. Additionally, these systems support credit card on-file services, which can improve payment collections.
Enforcing these procedures will allow for rapid payment of providers, eliminating any possibility of lost or delayed patient payments.
Monitor Performance
Data-driven revenue cycle uses certain metrics to give providers a better understanding of their financial situation and revenue cycle performance. Providers can receive a clear image of the areas in their healthcare organization where changes can be made by monitoring their financial performance.
- Some significant signs to monitor include:
- Accounts receivable net days
- Claim rejection rate
- The proportion of collections
Outsourcing RCM
Providers can also enhance their RCM by contracting with a different business to do it. Providers can ensure the success of their revenue cycle without expending excessive time on it by employing a skilled and educated organization to manage it.
Additionally, by outsourcing the revenue cycle management, physicians have more time to focus on providing high-quality patient care. Patients, healthcare providers, and administrative personnel all benefit from an increase in quick, accurate provider reimbursement while also sharpening the emphasis on patients.
Improving RCM for patients and providers
To keep up with technology and patient demands, the healthcare sector is continually evolving. New innovations are now coming into practice; these work for both the patient and the provider. Healthcare providers must therefore never stop looking for ways to enhance revenue cycle management.
By including stringent payment requirements in their payor contracts, Medical Billing Services in California may make sure that their revenue cycle remains effective. We promise to help providers maximize their revenue cycle so they can return to concentrating on what really matters—providing top-notch patient care.
Conclusion
Utilizing technology to track the claims process at every stage of its life, revenue cycle management is the process of managing claims, payments, and revenue generation. RCM is one of the best medical billing solutions to take your practice next level. This allows the physician who is billing to follow (view) the process from beginning to end and address any issues as they come up. A healthcare organization’s ability to generate a consistent stream of income that a well-managed RCM process enables to work.
Keeping track of claims, making sure payments are received, and making sure the organization rapidly handles refused claims are all part of the process. Denied claims can result in a lot of issues due to lost revenue opportunities. It goes without saying that the revenue cycle includes everything from correctly coding claims to ascertaining a patient’s insurance status and collecting copays. Efficiency and time management are key components of revenue cycle management, and the cycle can be impacted by the usage of auxiliary technology such as electronic attachment solutions and healthcare communication systems.
