In the medical billing process, Revenue Cycle Management is the key for any practice to smoothly manage its revenue and make the health care center financially stable.
The whole revenue cycle management system revolves around managing, identifying, and collecting revenues.
It has become essential for any health service provider to efficiently manage its revenue otherwise an outstanding account receivable can badly affect the operations of the services.
Steps of Revenue Cycle Management
The revenue cycle management system revolves around multiple steps. Some of them are described below:
When the Patient comes for the services, the first step for the revenue management system is to record all the essential details of the patient. It includes his name, age, address, etc.
Your front desk staff can note all these details with accuracy and these details are essential for the billing process.
Checking Insurance Coverage
The next step is to verify the insurance eligibility of the patient. In many cases, some services are excluded by the insurance coverage and the patients are unaware of it.
After checking the eligibility the next step is to make them aware of their insurance coverage and tell them that these services and procedures are excluded from your insurance scope and you need to pay for them.
In the next step, all the documentation is converted in the form of codes by the coding team. Because insurance companies process only those claims that are in the form of coding.
Submitting The Claim
When all the documentation has been done in the form of coding then the next step is to submit the claim to the insurance company. Your claim will be processed by the insurance company.
If there is no error found in the claim then it will be approved in case any error is found in the submitted claim then it will be rejected.
It’s one of the essential parts of revenue cycle management. When your practice faces a denied claim then your billing team must follow up. Check the claim and find the error and resubmit it.
And for the services that are excluded from the insurance coverage and patients are liable to pay for them then it’s the responsibility of a follow-up team to send them reminders to pay their dues.
How To Make Your Revenue Cycle Management Efficient?
It’s essential for every health service provider to manage their revenues at full potential. Here are some ways in which you can maximize your revenues.
Keep The Record With Accuracy
Record keeping is one of the first steps of the medical billing process and it should be accurate. This information is important to get the right coding done. So if your practice is successful in keeping the record then you can easily get the reimbursement.
Highly Skilled Staff
A highly skilled staff minimizes the chances of error in your billing activity. Your practice should spend more resources in the training of the staff or can hire a professional staff to manage the billing activity.
Reducing The Manual Working
There are higher chances of error in the manual form of working. The paper records can be lost and they are very difficult to manage.
On the other hand, you can lessen these errors by using the automation process, utilizing the latest EHR/EMR technologies and administrative tools, and cloud-based systems.
Efficient Coding Practice
An efficient coding practice is necessary to minimize the claim denial rates. While coding use CPT and HCPCS coding approved by the American Medical Association. Follow the set regulations and hire an expert coding team.
Give Your Patients An Alternative Payment Method
These services are exclusively for those patients that are liable to pay their bills. Many times patients can give your practice an instant payment because you don’t give them multiple payment gateways.
Some might prefer to use their credit/debit card or some might be interested in paying through any mobile application. Make sure that you give them maximum options for payment so that you can receive the revenues without any delay.
Timely Submission of The Claim
The insurance companies only approve those claims that are timely submitted. If your practice fails to submit the claim on time then your account receivable can expand at a significant amount. So a timely submission can save you revenues.
Tracking Denial Rates Frequently
Tracking denial rates are essential for any medical service provider. A consistent denial rate in your billing is the indication that there is something wrong that needs to be corrected. It might be due to frequent errors in coding or late claim submission or might be the inexperienced worker.
A team that monitors the denial rates can give you solutions to overcome them is essential for revenue cycle management.
Many times, patients are unaware of their insurance coverage. So after verifying the insurance eligibility it is the responsibility of your practice to make them aware of their insurance coverage and tell them that they are liable to pay the uncovered bills.
Outsourcing is one of the best ways to manage your Billing activity. The majority of the time your practice lacks resources to effectively manage the revenue cycle management. Either you have a lack of staff, improper infrastructure, or inexperienced staff or ineffective management.
A Billing service possesses a team of experts who can manage the revenue cycle of your practice. At the same time, they are managing the billing of many other practices so they better understand the regulations and latest trends and nature of different insurance providers.
Revenue cycle management is an essential part of any medical service provider. If you fail to get the desired results after all the hard work then you can outsource your billing activity.
Med-Miles can help you to achieve your goals. Our vision is to provide a smooth billing process with better solutions. We assure low denials rates with a maximum profitability ratio. Call us at (888) 598-9181 for more information.