For the growth of every business, the effective management of revenues is very important. When it comes to the health sector the health service provider usually lag in the management of their revenues. They usually face problems like errors in billing and failing to cope with the new regulation and policies.
The biggest challenge health Care service providers face is to give quality care to the patient with an effective RCM. The revenue cycle management solution is very important for any health service provider to not only manage the revenue flow but also give the best possible treatment to the patient.
Revenue Cycle Management Solutions
Revenue cycle management is a process that involves the proper management of the revenues of a healthcare service provider. A strong and stable revenue cycle is essential for any healthcare practice; it not only makes them financially stable but also they can give quality care to their patients.
For that purpose, the effective management of revenue is important for any service provider. Here are some ways which show proper revenue cycle management.
Acquiring The Details of The Patient
First, you need to ensure that you have all the essential details of the patient required for the claim creation. Before starting the treatment you need to note all the essential details of the patient like his name, address, social security number, and insurance provider details.
If you have done this correctly then you successfully achieve the first step towards a smooth revenue cycle management. Because if there are no gaps in the details of the patient then you can easily process your claim for the coding.
Assure Prior Authorization
The next step is also very crucial and this responsibility falls on the administrative staff of any health service provider. Authorization is the verification process to see the insurance eligibility of the patient.
Because some services are not part of the insurance coverage and if you rendered those services then your claim will be denied and you will not be in the position to negotiate.
It’s your responsibility to check the insurance coverage of the patient. So you can get proper reimbursement from the insurance company.
Avoid Coding Errors
Coding errors are very common in any medical billing process. And the chances of encoding are very high and it has been seen that many of the claims are denied due to wrong coding practices.
If you want to assure a smooth revenue cycle management then you need to seriously consider an error-free coding practice.
Most of the coding errors occur due to the negligence of the person who is performing this activity. There are other reasons too which are under coding, Upcoding, and incomplete or inaccurate information.
Highly Skilled Staff Is the Key
That’s a common problem with many of the health care service providers that they usually use their medical staff for the revenue cycle management purpose. This will not only affect their revenue stream but also they are taking a huge risk in terms of patient care.
In case any health service provider wants to effectively manage their revenues then they should invest in the upskilling of their present staff so they can minimize the probability of errors.
On the other hand, if they have efficient resources they can also hire highly skilled staff to manage the administrative and billing activity. A highly skilled staff is very important for any health care unit in terms of RCM.
Provide Payment Options as much as you can
Any health care service provider can use this method in case insurance companies are not liable to pay for the services because those services are excluded from the general agreement of the insurance and patients are liable to pay for those services.
Many patients are not able to pay their bills upfront after the treatment. In that case, you can give them multiple payment options if they don’t have money right now then they can pay through any kind of payment gateway.
Make A Payment Plan
If your patient is not able to pay for the services upfront before acquiring any kind of treatment then there are chances that they may switch to another health service provider.
In that case, if the treatment is not affordable for them then you can give them a payment plan so they can pay you on monthly basis for the treatment they received.
Patient Follow Up
While establishing a payment plan for the patient you need to develop a proper mechanism for the patient follow-up. Patient follow-up is very much essential and many health care service providers have a proper team for this purpose.
While if you are having a follow-up team then you should utilize digital communication to remind them of their dues. You can set up a patient portal. Also, you can send them emails and reminders about their unpaid bills.
Automation of the system
There are effective software Solutions available in the market which can help you in revenue cycle management and also managing the administrative work.
Also, there is Technology like cloud-based service which helps you to effectively access and manage your data on the cloud-based system rather than a server-based system which is vulnerable to damage.
From automation, you can simply manage your work because it has been seen that many of the service providers are still using a manual way of working, and the chances are very high if you are managing your finances through the manual way.
There are many EHR and EMR software solutions available and many software solution companies are also offering customized versions so you can simply integrate your software with any third party.
Try Outsourcing Your RCM
If you are a health service provider and you are looking for the best revenue cycle management solution for your practice then you must outsource your billing activity to a professional medical billing service provider.
Many health service providers do not have enough resources to properly up-skill their present staff and hire highly skilled staff to manage RCM and some service providers are not able to afford the expensive software Solutions.
Moreover, if any practice is managing their revenues then the patient care can be compromised. So in that case the best you can do is to outsource your RCM to a well-known Billing solutions company.
Med-Miles have the experience of over eight years in providing the best billing solution to their clients. We have effective strategies which assure low denial rates and clean claim submission.
Our follow-up team is very active in resolving all the issues and ensuring the transfer of fair share to the service provider. You can call us at (888) 598-9181 for further details.