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How to Optimize Revenue Cycle Management

RCM (Medical Billing) is the financial process in its entirety of operating a healthcare facility and seeing patients from the start of their care and registration through billing and reconciling a claim and posting those payments. The return of patients for additional visits and follow-up visits is considered a revenue cycle. Therefore, it is the process by which payments and money flow through your business.

The financial arm of your healthcare organization is referred to as a revenue cycle and the management of that cycle is what we call revenue cycle management. Learn four ways to optimize the revenue cycle management by reading on.

Tips to improve your existing Revenue Cycle Management process

1. Denial Management : Denial management encompasses a lot of your revenue cycle so it may result in low or no reimbursement. So, we have to consider closely what our top major denials are and what are the root causes of denials and how can we identify them. The top ones are No authorization, Non-covered service, Diagnosis/CPT, and Policy termed. Implementing mandatory eligibility and benefit verification each and every time before the patient encounter with the provider lot of eligibility-related denials can be reduced, also at the same time, PR’s like co-pay can be determined and collected at the time of patient visit resulting in a more streamlined patient revenue. The provider’s office should also make sure that if any procedure requires authorization, it is being taken care of before the patient sees the provider.

2. Investing in Technology : Providers have benefited from automation either. By eliminating the use of paper, we save a lot of human capital time. Hence, technology can be expensive and reduce your expenses, such as printing. As a result, your staff will be able to work on other important aspects of the office in addition to completing tasks. When you think about strengthening the RCM and shortening the timelines embracing technology is the key. Having platforms that seamlessly facilitate these tasks in the revenue cycle is very important we know that we want to avoid long times in A/R.

3. Staff Education : Investing in your employee’s education will build a very strong foundation. In today’s fast-paced multitasking economy it’s essential to educate your staff on process improvements as well. We never have enough time to educate when we’re dealing with patients which is probably very true and even a little bit low on the scale of the reality of things. Maintaining this process flows and making sure that the staff is balanced to handle how it works so that if there are people who are out other people know how to fill in for them.

4. Stringent A/R Follow-up : Yes, accounts receivable management is the most important part of the revenue cycle management having well-trained staff who knows how to get your medical billing paid is far more important than any other thing in revenue cycle management. Generally, the provider’s in-house billers or A/R team doesn’t get time to really call the insurance companies and remain on a call with them to clear the denial or find out what is happening with your medical bill having knowledgeable staff is the key as they would know how to tackle these insurance and should also be able to find out global denials and may advise the billing or clinic to prevent those in future.

Keeping these in mind your billing can be a breeze of fresh and streamlined revenue.

Meraki RCM Solutions, LLC entered into medical billing services business with the vision in mind that Doctor’s didn’t earn their medical degrees to streamline billing process or manage the medical billing staff, they spent years learning medicine to practice medicine and help the patient’s in need. We believe that a good billing company can take out the stress of dealing with all these processes and let the clinic do its job which is patient care. If you feel you need help in medical billing or any part of the process that you feel is over burdening your staff, we are here to lend our expert hand and provide the best available services. Reach out to us at 375-0472.

Tag: Medical / Billing / workers compensation

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