Tag - RCM

Revenue Cycle Management

The Ultimate Guide To Benefits of Revenue Cycle Management

Revenue cycle management permits healthcare providers to spot, track, collect and manage incoming payments for services provided.

The RCM method plays a vital role in maintaining money viability and providing exceptional service.

In addition to easily streamlining secure requests and payments, RCM will promote national, patient, and student engagement by strengthening relationships that build an improved sense of community and commitment.

Revenue cycle management can increase provider revenue whereas decreasing the time spent on body and clinical functions. which results in extra money and time dedicated to the patient and their treatment.

Preregistration is the 1st and most important step of  the revenue cycle method. Pre-registration allows practice to capture demographic data, insurance data and eligibility in period through a clearinghouse, typically whereas the patient continues to be on the phone.

Revenue Cycle Management Benefits:

Saves time: A good RCM ought to be designed to save lots of the time taken between the supply of service and receipt of payment.

Saves money:  Revenue cycle management systems offer insights into denied claims.

The Purpose of Revenue Management, specifically speaking, the aim of revenue management is to:

  • Connect systems and knowledge.
  • Manage assortment, revenue, and reconciliation.
  • Communicate with and interact with customers.

When these CORE solutions close in one system, they type a comprehensive image of AN institution’s revenue and money status—which is the final purpose of revenue management.

 Revenue Cycle Management Advantages

Revenue cycle management brings several advantages to organizations: quick and error-free payments/reconciliations, deep insights into discourse information, and higher service to users.

Integrating multiple systems:

  • Consolidates information into one accessible, period read
  • Eases multi-departmental revenue collections
  • Gives insights on payment experiences
  • Automating processes like causing invoices, process payments, electronic messaging users, playacting reconciliations, and generating reports:
  • Eliminates frustrating and expensive entry errors.
  • Significantly reduces the time departments pay playacting manual tasks
  • Knowing the standard and accuracy of finances, whether or not merchandiser services are presently operating well.
  • Collect revenue faster.
  • Give period, comprehensive, and significant understanding of knowledge.
  • Allow you to administer higher service to your customers.
  • Keeping your organization compliant with the very best security and PCI standards and privacy requirements.
  • Protects personal and monetary info from unauthorized access.
  • Maintains your smart complete name.

4 Steps within the Revenue Cycle Management Process:

The exact steps within the revenue cycle management method vary betting on the business (government, healthcare, or higher education), however the final steps are as follows:

Step 1: info Capture

This opening includes gathering info that’s needed before an Associate in Nursing invoice is issued. this could embody personal information like name, address, or checking account range. It conjointly includes forms for state verification, insurance eligibility standing, and authorization.

Step 2: Charge Capture and asking

Once services are rendered, they’re coded and calculated against any amount of money or different written agreement obligations. For instance, in an exceedingly health care situation, a claim is distributed to Associate in Nursing non depository financial institutions to be accepted or denied.

The right charge is announced, Associate in Nursing an invoice and clarification of charges are sent to the accountable party for payment, at the side of any notifications.

Step 3: assets Management

Next, claim standing is edited/updated (if necessary), bills are submitted, and payments are announced. Reminders and collections notices are sent, and late fees (if applicable) are more to the charge total.

Step 4: levy

The final step enhances revenue by gathering information into readable reports for driving data-backed selections that move Associate in Nursing enterprise nearer to its monetary goals.

Since the results of improper revenue cycle management are dire, having a sensible, structured, corroborated revenue management strategy is important. Here are the 3 commonest ways that to travel concerning it.

This can be the normal manner of managing revenue, however of late, it’s nearly not possible to try and do it on your own. Managing a whole revenue cycle with none skilled solutions, particularly as you start or still scale, is currently too difficult for many businesses to try and do on their own.

Organizations WHO do attempt to have it all themselves place in large amounts of your time and energy, just for this strategy to fail. Inevitably, that’s after they conceive of a decision within the professionals.

  1. Source RCM: 

Having Associate in Nursing other companies are available and taking over an organization’s revenue cycle management is helpful. There are some downsides, though, like:

  1. Ending up with a fragmented body method
  2. Hold up on misaligned goals
  3. Having a slim read of your own information

Use a Revenue Cycle Management System:

This can be the revenue management strategy CORE suggests. Having Associate in Nursing panoptic software system resolution that you simply manage and that we support provides your organization the simplest of each worlds. You’ll get the advantages of:

  1. Total management
  2. Seamless integration
  3. A simplified method
  4. machine-controlled tasks (invoicing, messaging, reconciliation)
  5. merchandiser services
  6. Resource management (ticketing, events, etc.)
  7. a whole read into decision-driving information
  8. PCI compliance and security that exceeds the industry’s highest standards
  9. 24/7 support from extremely trained analysts and solutions engineers

Who Advantages From Revenue Cycle Management?

Among several others, government, healthcare, and better education are 3 major industries that profit greatly from revenue cycle management.

The answer may be a one-stop, resistance, secure receipt-to-reconciliation payment and engagement platform that resolves the various challenges throughout the revenue cycle.

Local, state, and national agencies have constituents that need fashionable, convenient interactions, particularly as municipalities still evolve. Government agencies want revenue cycle management to alter payments and boost arriving revenue collections, up their constituent’s overall welfare and satisfaction.

Health care suppliers have patients WHO want positive engagements and personal interactions as they create medical asking payments. Suppliers ought to use revenue cycle management to alter payment collections and result in improved patient and workers outcomes.

Education establishments have progressive students WHO expect technologically advanced payment solutions and additional connected fields. establishments will use revenue cycle management to optimize arriving financial gain by understanding and appealing to student and family desires.

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RCM Solutions

Sick And Tired Of Doing RCM The Old Way? Read This!

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.

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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

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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Medical Billing

Is Outsourcing Medical Billing and RCM for Your Pediatric Practice a good option?

Medical billing and Revenue Cycle Management (RCM) is a huge process that is crucial for both clinics and independent medical service providers. 

To assist with this task many Medical Billing firms have come into existence that allow healthcare professionals to outsource their task of RCM.

Some may argue that outsourcing medical billing might be a risk, however, people also suggest that outsourcing the RCM process allows clinics and pediatricians to give more time to their patients and improve the quality of their service. 

Let’s look at whether or not outsourcing RCM is a good decision!

Why you should outsource Medical Billing and RCM?

  • Lower Costs

Medical billing in-house comes with its costs. The set-up costs of buying desktops or laptops and also installing the desired software for RCM cannot be ignored if you want to introduce in-house billing. 

Then comes the salaries of the people who will be responsible for the medical billing and their training costs. All these costs will not be incurred if you choose to outsource your RCM to a trusted and experienced company. 

Medical Billing companies earn by cutting a certain percentage off the bill the company receives which is quite low looking at the costs of in-house billing.

  • Less Pressure on employees

With in-house billing employees always stay curious about the accuracy of their billing. Employees as a result end up giving more time in the billing process rather than what their main job is. 

Outsourcing RCM relieves employees of the stress and allows them to focus on the job they were hired for.

  • Greater Consistency

In-house billing gives better results if done by a small group of people. However, what if one of the employees gets sick or goes on his/her annual holidays. 

This won’t be an issue with outsourcing medical bills as they will consistently process your bills ignoring what goes on in your firm regarding your employees, all they are concerned with are the bills of your customers.

  • Respond better to changes in Medical trends

Medical Billing companies have more knowledge of the requirements of the bills and the upcoming changes that will take place. 

Outsource companies respond better to the changes than in-house billing because it is what they do 24/7. 

Responding to changes for in-house billing companies will be slower and more complicated as they will need to retrain their employees and might have to update software.

  • Errors are reduced

Employees in medical firms have a lot of things in their mind while they are on duty regarding the patient which makes them prone to mistakes while billing the patients. 

They might enter the wrong name or enter the wrong code which affects the cash flows of the practice.

Employees in the medical billing companies are very well trained and their job is to bill the customers and have no other tasks on their mind which reduce errors.

Signs that you need to outsource your Medical Billing

Using in-house billing for years helps companies to develop a certain flow of how they bill their customers and how they use their software.

However, there are certain signs that your practice is not doing the right job in billing your customers and it’s better you opt for outsourcing the medical bills.

  • Pending Registrations

When your employees start ignoring steps like completing the authorization of customers and following up on claims it breaks the flow of the bills. As a result, there are missed entries in the company’s accounts which causes complications. 

  • Price transparency not provided

A company’s customer always needs to know about the information costs they are incurring. If an employee fails to do so it means he/she doesn’t have enough knowledge about the billing system. This is a major sign that you should pass on the work to professionals.

  • Non-electronic methods of billing used

Keeping all the files of non-electric bills safe in a locker can be a confusing task. If your firm is not eligible enough to use electronic devices for your billing systems then it’s better you outsource the firm’s RCM.

  • Coding errors are seen on a consistent basis

Group of employees that have been over-worked for years tend to make small errors like entering the wrong code, especially as codes change frequently. However, these small errors have a huge impact on the billing system of the company.

Outsourcing a firm’s RCM is a great way to make your work more productive and consistent. It allows your employees to completely focus on the customers which gains their trust for the future.

However, what you need to take care of is choosing an authorized outsourcing firm and you can do just that by contacting Med-Miles by email (info@med-miles.com) or by calling us at +1888-598-9181 for your medical billing solutions.

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