What is RCM in Medical Billing ?
Every practice or medical organization acknowledges the importance of revenue cycle management in healthcare to some degree. However, an organized, well-designed approach to the healthcare revenue cycle management system 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. He/she 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 insurance claims.
Here are three reasons healthcare 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. Proper healthcare revenue cycle management services maximize 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.
- The RCM system 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.
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. However, an effective RCM system expands the use of information technology to make data management more efficient.
Outsourcing hospital revenue cycle management to medical billing specialists relieves practitioners from having to figure out how to integrate the various software programs. Everything is conveniently configured through digital records and allows the practitioners to focus on patient care. It also greatly reduces the amount of paperwork required for healthcare revenue cycle management services.
A small practice is unlikely to be able to afford a full-time IT professional to keep all the electronic systems running. Even though a large institution will have in-house IT staff to manage their computers, it would also be difficult for them to stay up-to-date 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. Therefore, having efficient RCM solutions in place that incorporates changes in medical coding and billing is essential for every size of the medical organization
Revenue Cycle Management Helps to Establish Effective Financial Policy:
In large medical organizations, policies often become disjointed when each department creates its own guidelines in response to different issues. Smaller practices may lack a written policy manual altogether, but it is important to have written policies available to all employees for every organization.
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.
A clear healthcare 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.
Hospital revenue cycle management healthcare organization medcare mso has been handling RCM for medical organizations of all sizes and in all specializations since 2012. Despite having certified and qualified professionals for healthcare revenue cycle management services, the company has state-of-art technology to strengthen your reimbursement practices and drive financial growth.
Medical facilities across the U.S., including clinics, hospitals, imaging centers, and labs, outsource their healthcare RCM to Medcare MSO. If you are struggling with any or all aspects of revenue cycle management services, contact us today for a no-obligation demo of our process.