You’re an independent and relatively new medical practice available in the industry. Other than having professional doctors and some staff onboard, what else is crucial for your practice? Outsourcing a Revenue Cycle Management company (RCM)!
While dealing with unprecedented challenges for your practice, you can’t skip managing your revenue cycle. Delayed payments, claim denials, staffing issues, and a plethora of infrastructure issues can be solved with a proficient revenue cycle management company.
Clinics and health organizations are facing revenue problems now more than ever. Whether you have a fee-for-service or value-based care model, a reduced rate of reimbursement and an increase in expenses is always going to be a snag.
While you are struggling to deliver a more quality patient experience, when you throw staffing issues and incapacitated resources into the mix, you’re going to fall behind real quick.
This is where the revenue cycle management company comes in. Most people think this solution is only for billing and coding services. But RCM services are so much more than that.
Did you know that during Covid-19, almost 75% of medical practices opted for RCM services to keep their workflow and practices afloat? Well, the percentage is still increasing, and here’s why;
How Promising is RCM for Your Practice?
Revenue cycle management tends to identify any sort of friction providers face in their revenue cycle. Doctors can maximize reimbursement rates and expand income with optimized RCM billing services. Here are some pointers that might do better convincing for you;
Eligibility Verification & Pre-Authorization
When a patient schedules an appointment with a provider, the first step is to register the patient and enter the details into the EMR. This step is crucial as the patient information needs to be accurate; you need the insurance info of the patient and check whether the insurance offers coverage for a specific treatment.
Even if the patient already has an account with you, RCM encourages you to complete this step thoroughly. Ineligible insurance or incorrect information can result in delayed payments for the doctors and claim denials. This also means more work burden for the provider to check the complete information again to remedy the situation.
Charge Coding & Capturing
Charge coding and capturing means turning the services offered to the patients into billables using universally recognized medical codes. Insurance companies use medical codes to access the revenue cycle to calculate accurate reimbursement amounts.
The insurance companies can deny the claims submitted if the correct medical codes aren’t used. And this results in delays in proper reimbursements for the practice.
It costs a lot of time and management on the provider’s end to appeal the denied claims and investigate the process. The revenue cycle management company makes sure that correct medical codes are submitted, reducing the amount of denied claims significantly.
90% of claims denials are easily avoidable when RCM billing services are in place. From lessening administrative burden, detecting errors and finding resolution, and avoiding any sort of healthcare fraud for your practice, RCM services overarch the goal of maximizing revenue for the providers.