Revenue cycle management is the financial process with which healthcare facilities track patient care episodes from registration to final payment. An efficient revenue cycle keeps the practice financially healthy and directly impacts patient care. When the revenue cycle is healthy, more revenue is coming in which means the facility can invest in better resources which ultimately improves patient outcomes. There are many steps in the revenue cycle, medical billing being one of them. In this article, we will discuss how medical billing services can help simplify revenue cycle management.
Challenges in Revenue Cycle Management
Revenue cycle management can be tricky. Some of the most common challenges providers face in revenue cycle management include:
Much of the revenue cycle depends upon the accuracy of data. Data inaccuracies, incorrect coding, and failing to confirm a patient’s insurance eligibility can all negatively affect your revenue cycle. Error in claims can even result in claim denials and revenue loss. Moreover, non-specific bills can sometimes cause a patient’s balance to be ambiguous. When there is minimal pricing transparency or when the amount is unclear to them, patients may leave their bills unpaid.
The majority of practices still rely on manual claim processing and follow-up. These can be very unreliable and time-consuming for your staff. Moreover, most practices don’t even ensure efficient claim-tracking. Tracking every stage of the claims process to find any errors that can result in rejections or denials is crucial as these errors may cause reimbursement delays or claim denials. Without the necessary follow-up, these denied claims may even go unnoticed.
One of the most important aspects of RCM is compliance to the different regulations and requirements that govern the healthcare sector. Failure to code and bill according to these regulations results in claim denials, delayed reimbursements and revenue loss/ Your staff must stay updated about the most recent changes and standards because these regulations govern the way you code and bill. It is important to leverage technology and tools that can assist you in streamlining your RCM process, ensuring compliance with the ever-changing regulations. You must establish and adhere to policies and procedures that are consistent with the standards and guidelines.
How Medical Billing Services Can Help Simplify RCM
Accelerates RCM Process
Medical billing is one of the most crucial steps in the revenue cycle. In revenue cycle management (RCM), medical billing services can help in managing the common billing procedures, from the gathering of data to the final billing stage. Efficient medical billing services can help streamline billing processes which will help speed up the revenue cycle. It helps accelerate payment processing and avoid billing errors.
Improved A/R Functions
Accounts receivable (AR) refers to the monitoring and collection of insurance and patient payments for the providers’ services. Efficient medical billing in RCM reduces the time it takes to provide medical services and collect payment. By leveraging medical billing services, providers can make sure that patient data is accurately collected, and accurate claims are submitted on time. Providers who make errors and inaccuracies are vulnerable to insurance claim rejections and longer AR timelines.
In this value-based healthcare landscape, patient experience is of the utmost priority. Medical billers ensure claims are submitted accurately and payments are handled on their due time, allowing physicians to concentrate on providing high quality healthcare services. As accurate claims are submitted, the practice experiences an increase in revenue. Meanwhile patient outcomes improve, thus improving the reputation of the practice.
The healthcare industry is known for its ever-changing regulations. These regulations and compliance and rules must be followed by medical billers, however most billing staff fail to keep up with the umpteenth number of updates. Leveraging medical billing services ensures providers gain access to medical billing staff that is trained about the most recent regulations and rules in healthcare. This leads to a significant reduction in medical billing errors.
Outsourcing your medical billing to professionals helps increase efficiency. Providers do not need to waste time on manually sorting through documentation and figuring out complicated billing processes. This helps save the provider’s time as they do not need to figure out the various processes that constitute the revenue cycle, including claim submission and tracking. This increases practice efficiency and improves clinical operations.
In this day, analyzing the operations of your practice is key in looking for any mistakes and improving your operations. When you leverage medical billing services, you can access real-time analytics of the financial operations of your practice. These analytics can give providers a complete picture of their practice’s financial situation and help them make decisions with the help of reporting, and analytics.
Revenue cycle management is not without its challenges. Thankfully, providers can leverage medical billing services that can help them improve their RCM operations and ensure their practice receives maximum reimbursements and timely payments.