Revenue cycle management (RCM) is the process used in healthcare to monitor and collect money from patients. Revenue cycle management starts when a patient is scheduled for a clinical visit and ends with the final payment for the healthcare services provided. The revenue cycle is “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue,” according to the Healthcare Financial Management Association (HFMA). The highest possible reimbursement for services is ensured by using best practices in the revenue cycle.

 

Optimal Techniques to Enhance RCM

 Follow are the main techniques to enhance Revenue Cycle Management (RCM)

 

Center the Process Around the Patient

Revenue cycle management optimized healthcare facilities understand the need for improved patient relationship management. The practice gains a patient’s loyalty if the staff takes proactive steps to raise patient satisfaction and foster a good rapport. The patient should be given written and verbal explanations by the staff about their financial obligations, available payment methods, and what to anticipate from their visit. The more interactions patients have with staff about the medical billing process, which many patients find confusing, intimidating, and frustrating, the more likely it is that they will pay the provider back. 

Or get practice audit and reporting services from Optimedservices.

 

Obtain Payment From the Patient Before Providing Services.

When patient financial responsibility is unpaid or paid late, healthcare revenue cycles slow down or stop. Hospitals and medical practices run the risk of not getting paid in full for the services they provide. Since high deductible insurance plans are the norm, it is unfortunate that more than half of patients with outstanding medical debt never pay it off. Sadly, this situation is unlikely to improve anytime soon.

 

Technology Investing

It might seem as though Medicare and Medicaid will always reject any claim you submit. If you haven’t made an investment in front office service to keep you abreast of payer requirements and diagnostic code changes, this might not be too far from the truth. When you do receive reimbursement, you might discover that it’s for less than you originally requested.

 

Investigating unpaid claims, fixing errors, and re-submitting them all take time. If your practice is subject to a TPE from Medicare, the cost is even higher. Prior authorizations, eligibility, medical coding, and billing can all be streamlined with automated software systems. Modern technology with automation expedites reimbursements while reducing the amount of time staff spends resolving unpaid claims.

 

Denial Control

If the aforementioned best practices are not followed, claims may be rejected. Any hospital or medical practice must monitor and track denials in order to spot trends and determine their underlying causes. The entire staff should participate in a denials prevention program that emphasizes standardized procedures to reduce the risk of denials.

Best practice denial management programs can decrease the following:

accounts receivable, boost cash flow, reduce the volume of denials, and lower the cost of collection, But you can control all these with Optimedservices. 

 

Quickly Submitting Claims

Many healthcare organizations miss filing deadlines and don’t submit claims in a timely manner. Medicare permits one year from the date of the service for the filing of claims, whereas many private insurance companies only permit 90 days. Claims go unpaid if deadlines are missed, and the practice is forced to write off clinical services. To ensure that these deadlines are met, processes must be in place.