RCM

Revenue Cycle Management

Revenue Cycle Management: Get Paid For What You Do

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:

  • Patient Details

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.

  • Check Code

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. 

  • Follow-ups

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.

Financial Responsibility

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

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. 

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RCM in Medical Billing

RCM in Medical Billing: 6 Strategies You Need To Follow

Ensuring effective RCM in Medical Billing and also providing excellent service to your patients is not an easy task.

Medical practices looking to balance these functions often consider installing medical billing software in their systems for efficiently carrying out revenue cycle management of their business. Medical billing software saves time, cuts costs, and minimizes errors. 

Furthermore, it speeds up claim reimbursements, you also stay calm by knowing that your revenue processes are in good and professional hands.

Medical practitioners, on the other hand, can focus better on the reports of patients rather than the statements of your business. 

What Is A Medical Billing Software?

Medical billing software is an application for computers that enables medical businesses to automate their healthcare billing process. Medical practices use this software to effectively improve their optimized revenue, reimbursement rates, to sustain the financial situation of their businesses.

Why RCM Is Needed In Medical Billing?

Every medical billing company needs to have a strategic and planned approach to handle every section of their billing process, starting from the patient registration to follow-ups and also the denial management involved in the process.

Having the right technique and a dedicated and hardworking team that understands the importance of handling each medical claim, equipped with the knowledge that they are the financial aspects of their customers is very necessary to handle medical billing and achieve business goals successfully.

Every claim handled in the process of RCM is associated with the firm’s revenue, therefore an effective RCM can play a crucial role in Medical Billing.

Advantages Of RCM in Medical Billing

Pre-Registrations

This feature of RCM saves a lot of time. When a patient visits you for the first time, the normal thing to do is that they usually share details such as their insurance history and medical history.

However, with the help of technology, in the case of medical billing software, we can now skip this step during the patient’s visit as with the help of the software staff members can verify their insurance even before they arrive, which improves the personalized experience as well.

With medical billing software, details like a change of the patient’s insurer or the terms of their existing policies can also be updated for future reference.

Integrated Scheduling

With the help of medical billing software, people no longer have to stand in long queues or call the desk to book appointments. This has now been made easy due to the applications integrated into the software.

A strong scheduling system in the RCM software displays details about the physicians and the times they are available. In case the patient misses an appointment, they regularly receive automatic reminders. The staff does not have to worry to enhance the process and focus on key tasks.

Automated Processing Of Claims

Automation drastically reduces the cost of the medical billing process from beginning to finish. It helps you to keep an eye out on the status of claims in account receivables as they happen and look at why some claims were processed why the others weren’t.

It also allows you to follow up on troublesome claims by sending reminders, tracking denied claims, and much more. Furthermore, you will also receive detailed analysis and auditing reports on the operations of your medical practice.

Fewer Chances Of Recurring Errors

Medical billing software nowadays uses accurate patient data stored in the system, which creates an efficient and smooth RCM billing process. It is essential to spot errors quickly and fix them in an instance. This reduces the number of rejected claims and speeds up the flow of revenue into the firm’s accounts.

Managing Of Accounts And Finance

Even though your staff is very efficient, when it comes to dealing with accounts, it is always best to take advantage of the technology and install accounting software for your firm. This helps out a lot in managing the collections, creating accurate financial reports, and generating statements.

This results in a reduction in the margin for errors but also speeds up the process.  Advanced systems also allow firms to ease paying for consultations that help patients. This is an additional benefit, especially since the COVID-19 pandemic, social distancing is the way forward.

Security Of Data And HIPAA Compliance

Nowadays, to protect your patients’ medical data, you should consider medical billing software that is compliant with the Health Insurance Portability and Accountability Act or HIPAA. As storing personal data about your patients in your system is quite sensitive, it is a great responsibility to keep this data safeguarded with software that includes the best and up-to-date security features.

This increases the credibility of the firm’s practice and enhances your level of confidentiality. Ensuring patient data security and managing the RCM by complying with HIPAA is something you should always keep in mind if you decide to install medical billing software. 

Credit Card Payment

In today’s era, patients opt to pay using credit cards as it is among the most convenient methods of payment. The latest RCM medical billing software makes it easy for you and your staff to process payments using credit cards, both online and also in person. 

Strategies For An Effective RCM

RCM is a vast and complex process to handle, as there are many areas where the staff need to consciously take care of as it ensures the claims are reimbursed accurately and completely. Any miss-handling of the medical billing claims during any part of the RCM process can cause denials and loss of revenue. Here are a few areas to focus on for best results.

  • Ensure workforce collaboration by making sure all the teams involved in RCM are in perfect coordination. This ensures the claims are processed as per the requirement of HIPAA.
  • Constantly provide training, as this ensures that the staff involved is up to date with the trends and changes.
  • Organize regular audits which help in finding the causes for the decrease in successful claim percentage.
  • Utilize automated software and decrease errors, as a result increasing efficiency
  • Having an evaluation of your process strategies constantly helps you to keep revised on the guidelines and regulations that need to be followed to help stay on top and in control.
  • If you can’t handle the RCM on your own then it’s best to hire RCM billing services to an established and professional medical billing partner like Med-Miles. This helps to provide a quick solution to all your medical billing needs

Looking To Improve Your Medical Billing Process? Give Us A Call!

Having read the benefits of adopting the latest and HIPAA-compliant medical billing software, it is easy to see that adding effective software to your RCM system can be profitable for your business. 

Med-Miles provides the latest medical billing software around, and also allows you to outsource your RCM billing service.  So what are you waiting for? switch to efficient medical billing software ASAP for the betterment of your healthcare business.

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RCM

RCM: The Art of Compassionate Billing – Reasons to Put Patients First

The most common answer, when people ask about the area where medical practitioners have to be the most compassionate, is the clinical side of things. This is the right answer, however, it’s not the only place where people should be careful. 

Getting billed out of nowhere is a real surprise and one that happens quite often. Not only does it hit you financially but emotionally as well.

People think that getting insurance might save them from such costs, but as people spend so much time providing documentation, and following up, these costs still manage to creep in from somewhere.

Surprise billing adds frustration as it fails to uncover costs or to make matters worse they appear when the patient thinks everything has been paid for.

Intimidating the collection of bills stresses people out nowadays, especially during a crisis like COVID-19. A more compassionate and open approach to billing helps patients understand their financial situation so that they know what to do to build long-term loyalty, something that the providers look to aim for, more so in this time of crisis.

We Need It Now More Than Ever!

Surprise bills amount to millions of dollars each year. According to a poll where people were asked about the costs that worried them the most revealed that 2 in 3 adults said unexpected medical bills.

This is a problem as on average 1 out of 5 emergencies and 1 out of 6 in-network hospitalizations have one bill that’s not related. 

Things are starting to change for the better with new rules and regulations, like the No Surprises Act, however, people still are not aware of these rules.

According to a recent study, only 5.6% of hospitals were fully compliant with the new regulations, and that only 1 out of 10 patients know that hospitals now need to post prices online. 

Recovering from the COVID-19 pandemic, many people are facing financial uncertainty due to unemployment and other challenges. Hospitals are coping with the financial issues from the COVID-19 pandemic, a good enough cash flow is more important than ever.

The bigger and more important challenge is to have some compassion towards the patients so they feel supported by their providers.

What Is Compassionate Billing-RCM & Why It’s Important?

Compassionate Billing is the practice that healthcare providers carry out by supporting patients with empathy and care throughout the billing process, this promotes patients in taking control of their finances, managing payment plans, and finding other modes of payment, improving health as a result.

For effective communication with patients regarding payments, caregivers convey kindness to the patients in every possible way. By this simple act, caregivers can turn a stressful situation into something that helps consumers feel cared for.

Working closely with consumers should be crucial by using modern ways of communication. Below we discuss why compassionate billing helps and how it should be done.

Flexible Payment

The size of monthly payments does not negatively impact the rate, suggesting that patients want to cover their duties and choose the number of bills that fit their budget. More options, due to compassionate billing, both the patients and providers win.

Patient Care Mindset

It has happened in many cases, when second or third statements are left unpaid, the patient often is removed from your team’s mental side. This shouldn’t be the case.

Medical providers should train the medical billing team so that they remember that billing is the crucial and final step of the care and treatment that they deliver to help patients be healthy – not just a regular exercise that manages income.

Data-Driven Payment

Just like medical don’t provide identical medical treatment to every disease and patient, then processing all your patient’s accounts uniformly doesn’t make sense either. Every patient and their bill is different.

Medical providers should invest more in comprehensive data and advanced analytics. By this providers understand an individual’s ability to pay. Making the payment process positive as they assess and assign each patient based on their unique financial situation.

Easier Payment

Minimizing barriers and bumps during payment is crucial towards compassionate bill collections.

In this world of high technology, providers should start to offer multiple payment options that include, telephone, mobile and online portals, so patients pay in a way that’s most convenient for them.

As a result, freeing up staff to help the patients who need a little extra help in understanding their statements.

Personalized Payment Plans

Providers and patients come most in contact during the process of Medical billing as money is a sensitive topic for humans in general. Also because bill statements can be overwhelming and difficult for patients to understand.

Customizing patient statements allows providers to simplify the patient’s bills quickly and easily, turning a  confusing process into something simple of more value.

Personalized messages and updates can turn the billing experience easier for them and simpler for you. Not only saving time but increasing customer retention in the process.

Of course, billing is only one part of the medical system that needs a modern kick, but it’s important to keep in mind that billing can be a pleasant process when done with compassion, and understanding.

By treating consumers as people with unique circumstances, we can support their needs, meet revenue goals, and collectively take a big leap forward into a better healthcare system.

To help you with this cause, medical experts here at Med-Miles can help automate and simplify your billing process, so that you don’t worry about your patient’s satisfaction in the future.

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Payment Posting

5 Reasons Why Payment Posting Is Necessary For Medical Billing Process

Payment posting plays an essential role in the medical billing process. You can use it to assess your revenue cycle management system and discover ways to improve your revenue stream.

Payment posting may sound like a very basic task. But, one mistake can cause many problems, like denied claims, late payments, etc., which can be troublesome for a healthcare provider.

What Is Payment Posting in the Medical Billing Process?

The payment posting process involves entering payments into the billing software. It helps healthcare practitioners or organizations to assess their financial position. 

It also includes information regarding adjustments, write-offs, denied claims, and many other factors related to the economic image of a healthcare provider.

Why Payment Posting is Necessary for Medical Billing?

A health care provider has to deal with many claims daily, and sometimes claims get rejected because there was some payment error in the system. 

Payment posting offers a healthcare provider’s team evidence and a piece of information when they approach a denied claim, prior authorization requests or any non-covered services. In the end, it helps to find issues and makes the process smooth for everyone. 

Here are the 5 reasons why you have to focus on accurate payment posting in the medical billing process:

Reasons Why Payment Posting is Necessary 

Denial Resolution Time Is Reduced

Every day your denied claims become a part of your accounts receivable, and if not collected, they become a part of loss because nobody knows how it occurred and then they will just forget about it. Payment posting helps you reduce the time for denials, and it gives you information on what claims were rejected and why they were rejected.

It keeps you up to date with all the coding and billing requirements needed by insurance payers, so your claims get processed faster, and you save yourself from the losses. Getting payments faster is vital because the longer a bill is not paid, the more likely it will never be paid.

Allows Correct Claims Submissions

If the payment posting is not done correctly, it can lead to denied claims. This is why accurate payment posting in medical billing can allow correct claims submissions. If the first payments are posted correctly, the secondary and tertiary payers can be charged accurately.

It helps the medical office stay updated with all the billing and coding rules to submit the claims correctly.

Identifying Problems in RCM Gets Easier

When payments are posted to the clients’ accounts, the revenue cycle becomes easier to analyze. It helps you to find possibilities and ways to improve your financial image. And a logical analysis can help you improve the accounts receivables and increase the overall profitability of healthcare providers.

During this process, you may find a payer who has a history of denying claims due to failing to show medical necessity or maybe some other reason. This way, you will detect the problem to avoid them in the future.

Scale-up Current Processes

Accurate payment posting can improve the current RCM process. At times, it is the negligence of management teams that are affecting the overall revenue cycle process.

Once a problem is discovered, it is essential to take action either if a process has to be added, refined or eliminated.

Resolves Repeated Problems

Many problems in the revenue cycle can easily be solved by correct payment posting. The payment posting in medical billing does not only involve payment posting, but it includes adjustments and denials as well.

It provides a tracking system for the claims so that the medical office staff can find out the trends in rejected claims. They can be trained to find out why those claims were denied and how to correct them, so the next time, those claims wouldn’t be rejected by the same payers.

Outsource Your Payment Posting and Medical Billing Process to Med-Miles LLC

Payment posting is an important part of the medical billing process. For healthcare practitioners and organizations, coding and billing rules are more difficult to understand and follow. This is why outsourcing can be beneficial because third parties have more expertise and experience than you do.

Med-Miles LLC has been providing medical billing services for over eight years. We cannot only handle your payment posting in medical billing but the whole process, including denial management, payment hunting, and patient services. 

In a nutshell, we can handle the entire revenue cycle management system for you. So you can keep doing your practice, without worrying about the operations.

You can know more about our medical billing services by sending us an email at info@med-miles.com, or you can have a talk with experts directly at +1 888-598-9181.

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Why Revenue Cycle Management Is Important For Healthcare Industry

With a growing population, the subsequent rise in demand for healthcare facilities alongside claims to various medical reimbursements has rendered the medical bills profoundly blunder inclined.

Healthcare providers are encountering a rise in the cost of operations and a reduction in revenues due to the changing government controls within the healthcare field. For this reason, revenue cycle management plays a crucial part in how organizations can work on a day-to-day premise.

Though, healthcare organizations must have policies and practices in place for remaining financially fit.  Managing revenue is vital for the healthcare industry but it may not be the primary focus of healthcare providers. Every practice or healthcare organization recognizes the significance of RCM to some degree.

However, organized and well-designed revenue management needs to be done to ensure proper and systematic revenue supplies, equipment, and salaries. It went without saying that a decrease in their financial stability can divert their concentration away from their core purpose.

Let’s understand the importance of revenue cycle management.

What Is Revenue Cycle Management?

The hospital revenue cycle stands so crucial because when it gets to the healthcare realm, it is not only the patient that the hospital should focus on but similarly financial side of the patients also requires equal consideration or attention. So, what exactly is RCM in medical billing?

Revenue Cycle Management revolves around the patient collection issues and the efficiency of claim submission. Revenue cycle management starts when the patient enters a relationship with the healthcare organization.

He/she proceeds through the whole preparation until the treatment is done and any balance on the account is paid off. It incorporates dealing with claims, handling installments, and managing payments with disparities, with respect to insurance claims. In simple terms, it consists of the entire life of a patient account from creation to payment.

Revenue cycle management (RCM) is evaluated as the revenue driver of healthcare. It includes the process that will take the hospital events and turn them into dollars for the organization or health system. While there are different variations between the healthcare provider and payer types and how they are handling the healthcare specifics.

Traditionally, healthcare revenue cycle management includes delays in the patient’s treatment and care and it is also associated with the long-winded claims submission process.

However, it is important to ensure the RCM process in a timely manner in order to provide proper care or treatment and medical training.

Why is Effective Revenue Cycle Management Crucial?

On the extreme side of Revenue Cycle Management, there is an issue of outstanding payments that will lead the healthcare providers to bad debt. Managing the collections process is not always easy, it will distract the concentration away from providing valuable care and treatments to the patients.

Most of the providers consider bad debt as a potential revenue loss. However, efficiently managing revenue cycle management process steps may help healthcare providers to decrease the number of matters that will lead to bad debt. Moreover, all the problems must have a solution.

One powerful solution to resolve this issue is to contact a third-party Healthcare revenue cycle management company.

What Does Revenue Cycle Management Cover?

According to HFMA, there are some factors involved in the revenue cycle management of the healthcare organization:

  • Charge entry, claim submission, and daily submission
  • Electronic submission and remittance
  • Payment posting and payment hunting
  • Insurance follow up, denial management, and appeals submissions
  • Patient billing and services
  • Practice analysis report

Reasons Why Revenue Cycle Management Is Important?

Here are some reasons why Revenue Cycle Management (RCM) is important for your practice with respect to the size and specialization.

Streamlined Billing Process:

Apparently, an adequate billing and payment process is the main focus of the healthcare providers in order to robust the revenue stream.

However, by partnering with a third party, you can save your time and administrative costs. Efficient healthcare revenue management processes can lead to maximizing payments by proper handling of claims rejection and denials. Revenue cycle management streamlining process includes:

  • It simplifies the process by providing clear terms of the billing and payment collection cycle.
  • Uses EMR/PMS software to enter the patient information and demographic data.
  • Revenue cycle management software submits an electronic eligibility request to the insurer.
  • Resolves authorizations and verification problems through electronic modules.
  • Involves the Electronic scrubbing process to capture errors before the claim submission.
  • Monitoring the submitted claims regularly.

Adopting Healthcare Technologies:

The federal government has made electronic records, and the use of information technology mandatory for effective revenue cycle management, and to make more efficient data management.

However, outsourcing revenue cycle management to medical billing specialists saves providers time in figuring out how to integrate software programs.

All these processes are properly configured through digital records and enable the healthcare provider to focus on patient care. Moreover, it reduces the significance of the time of paperwork which is held necessary for revenue cycle management.

While the future of healthcare organizations completely relies on information technology. However, changes in the medical billing and coding process are essential for every size of the healthcare organization.

Helps in Establishing an Effective Financial Policy:

In large organizations, policies are sometimes disorganized when each department creates its own guidelines to resolve the issues.

A proper financial policy regarding insurance coverage is necessary for the smooth running of revenue cycle management, it not only informs staff about various expectations but also helps patients in the collection of copayments and balances.

Successful Revenue Cycle Management Process Steps:

Want to run a successful management process. Let’s have a look at some successful steps:

Improving Front- End: 

One of the most effective ways to improve your revenue cycle management process is to review your front-end operations that will help the healthcare providers to move their claims forward and identify the possible errors to maximize the revenue.

Moreover, it is important to ensure that there is no mistake in the patient’s balance account because this will end up causing problems and ultimately affect your revenue cycle management and claims reimbursements.

Verify Insurance Eligibility:

If the patient’s insurance is not verified at the start then it can cause problems in the future. However, it is important to ensure patient eligibility in order to reduce denials and revenue losses.

Training Staff:

By training your staff you can reduce the number of problems that will help the healthcare providers to streamline their front-end and improve clean claims.

Let Us Handle Your Revenue Cycle Management Operations: 

MED-Miles LLC has a team of professionals who are in the healthcare industry for more than 8 years with the view to providing healthcare providers revenue cycle solutions and services at a reasonable cost.

So, if you think of protecting your revenue cycle management then contact MED-MILES LLC today at +1 888-598-9181. Let our expert team handle your revenue operations.

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