Every practice or medical organization manages their revenue cycle to some degree, but an organized, well-designed approach to revenue cycle management can be the difference between a struggling practice and a thriving one.
Revenue Cycle Management (RCM) begins when the patient enters into a relationship with a healthcare organization and continues through the entire process until treatment is complete and any balance on the account is paid off. It includes handling claims, processing payments, and dealing with discrepancies regarding the insurance claims.
Here are three reasons RCM is important for your practice, regardless of size or specialization.
Streamlining of Billing and Payment Processes:
Clearly, proper billing and payment collection is at the heart of the revenue stream. This can be easily outsourced to a medical billing company to save your office staff time and reduce stress as well as increasing payments by reducing errors and efficiently handling claim rejection and denials. A complete RCM system streamlines the process in the following ways:
- It provides a clear set of steps for billing and the payment collection cycle and simplifies the processes involved.
- Patient information is collected and entered into software that coordinates with the various requirements of EHS/EMS and submits an electronic eligibility request to the insurer.
- Authorization problems are sorted out through electronic interactions, cutting down on staff time.
- The process of claim submittal follows, including “scrubbing” to catch errors before the claim is submitted.
- The status of submitted claims is accurately monitored.
- An electronic remittance advice (ERA) provides an explanation of the payment or denial, simplifying the process of correcting the claim if it is denied.
Adoption of Healthcare information technology:
Electronic records have already been mandated by the federal government, but a good revenue cycle management system expands the use of information technology to make your data management more efficient.
Outsourcing RCM to medical billing specialists relieves practitioners and office staff from having to figure out how to integrate the various software programs and digital records and frees them up to focus on patient care. It also greatly reduces the amount of paperwork required of them.
A small practice is unlikely to be able to afford a full time IT professional to keep all the electronic systems running, and even though a large institution will have in-house IT staff to manage their computers, those people are unlikely to also be specialists in the requirements of medical records and billing practices. A medical billing company will do all that in addition to ensuring that denied claims are resolved and payments are received.
The future of healthcare is certain to include more reliance on information technology, so having an RCM system in place that incorporates changes in medical billing, coding and reporting is important for every size of medical organization.
Revenue Cycle Management Helps to Establish Effective Financial Policy:
In large medical organizations, policies often become disjointed when each department creates their own guidelines in response to issues that arise. Smaller practices may lack a written policy manual altogether, but for any size organization, it is important to have written policies available to all employees.
A clear financial policy not only informs staff about expectations, but also guides patients concerning the collection of copayments and account balances. It is important that patients understand your policies regarding insurance coverage and their responsibilities.
The RCM process clarifies all the steps of billing from the time the first appointment is scheduled through payment from the insurer and collection of any remaining charges from the patient.
Medcare MSO has been handling RCM for medical organizations of all sizes and in all specializations since 2012. Despite having certified and experienced billers and coders on staff who are experienced in just about all fields of medical specialization, the company is known for providing high quality revenue cycle management services at such a reasonable rate that it is seen as an income producer rather than a cost.
Medical facilities across the U.S., including clinics, hospitals, imaging centers and labs, outsource their RCM to Medcare MSO. If you are struggling with any or all aspects of revenue cycle management, contact us today for a no-obligation demo of our process.