Any medical organization or a private practitioner understands the importance of revenue cycle management. Having a well-designed approach to the healthcare revenue cycle management system creates the difference between a struggling practice and a successful one.
Revenue cycle management starts with the first visit of a patient into the healthcare organization. From that point to the patient's treatment, the entire process is part of revenue cycle management. It includes handling claims, dealing with discrepancies, and processing the payments.
Without proper revenue cycle management, no organization will be able to survive because finance is the core of any business. Let’s understand why it is so important for medical practice to have an effective revenue cycle management.
Streamlining the Billing and Payment Process
Accurate payment collection is at the pumping heart of revenue stream. Medical billing can easily be outsourced to various medical billing and coding companies. It saves a lot of time and the extra efforts of your medical staff and gives time to offer better patient care.
An efficient medical billing service can help your organization enhance your reimbursables by reducing errors and managing claim rejections or denials.
A full-fledged revenue cycle management can help you streamline your medical practice in the following ways:
- Your practice gets a protocol for billing and payment collections and simplifies the processes.
- The patient information is collected and entered in the software which coordinates with all the requirements of EHS/ EMS.
- The patient's eligibility is checked beforehand by submitting an electronic eligibility request to the insurer.
- Authorization requests are entertained electronically, cutting down the time taken by the staff.
- The documentation is checked thoroughly before submitting the claims, which significantly minimizes the denial rates.
- The status of submitted claims is accurately monitored.
Electronic remittance advice gives an explanation of why the payment is denied, making the error easy to understand. This simplifies the process of correcting the claim so resubmission can be done easily.
Adopting Healthcare Technology
Electronic records are mandated by the federal government for all healthcare providers. In addition to that, an effective revenue cycle management system expands the use of information and makes data management efficient and easy.
Outsourcing your medical billing and coding to a medical billing company is a very healthy practice if you want to provide better patient care. The billing practitioners are saved from the hassle of integrating various software programs into their system.
All the information is conveniently configured through digital records which allows practitioners to focus more on patient care. It significantly reduces the amount of paperwork needed for a healthcare revenue cycle management service.
Medical Billing Services for Individual Practitioner & Healthcare Organizations
Individual practitioners are very unlikely to be able to afford a full-time professional who manages and keeps all the electronic systems running.
Big healthcare organizations have their own in-house team who manages billing and ensures proper functioning of the systems. However, it becomes difficult for them to stay up-to-date with the latest requirements and guidelines changes in the field of medical billing.
If they partner with a medical billing company, they will take care of all the billing and coding guidelines along with the documentation involved in the billing process. They will ensure that your claims are error free and follow the latest guidelines created by the government or the insurer.
If any of your claims gets rejected, they will ensure that the discrepancy is rectified instantly so that the claim can be resubmitted within a provided time frame.
A medical billing company will ensure that you are reimbursed for the treatment you provided with a hundred percent certainty.
Healthcare will be getting more and more reliable on technology. This makes having an efficient revenue cycle management solution important so that your practice can easily incorporate any change in medical billing and coding.
The Benefits of Revenue Cycle Management
Identify & Resolve Medical Coding Errors
Once you take RCM services from any medical billing company, identifying errors that might occur in the coding process becomes significantly easier. This decreases the chances of denials because about 90% of denials are made due to some documentation error, technical issues, or improper coding.
If these errors are rectified before submitting the claims, it is approved on the first go and providers receive the reimbursements on time. They also don’t need to spend extra money on investigating denials.
Decreased Administrative Burdens
Once your medical billing is streamlined, it minimizes the administrative burdens because they don’t need to spend any more time on investigating and re-submitting the claims.
This as a result gives providers more time to invest in better patient care. The revenue cycle management’s complete focus is on front-end tasks which simplifies the interaction between the administrative staff and patients.
All the hassle of appointment scheduling, intake form completion, coding & billing process and claims processing are streamlined to enhance the experience of patients as well as healthcare providers.
Avoiding Healthcare Fraud
A major benefit of revenue cycle management system is the prevention of healthcare frauds and abuse done by patients. It may seem a bit dark, but a small section of patients does try to take advantage of loopholes in the system.
Healthcare frauds can cost billions of dollars to the healthcare industry every year. One fraud will cost the organization its revenue along with loss of reputation. It may be intentional, or unintentional but inaccurate medical coding and billing will lead the organization towards fraud investigations.
Some common coding errors include:
- Unrendered services
- Unnecessary procedures
- Inefficient supervision
- Low-quality procedures
Reducing Unethical Practices from Provider’s End
There is a chance that providers may up-code procedures which leads to higher reimbursement for them. It seems like a profit for the organization but is a very unethical practice.
Revenue cycle management emphasizes heavily on accurate data collection, coding, and medical billing services. It prevents providers from filing inaccurate claims deliberately. Also, a medical billing company is always updated with the latest guidelines and provision changes.
How Unify Healthcare Services Can Simplify Medical Coding
Unify Healthcare services is a medical billing and coding company that takes care of all the billing requirements for many organizations. We have talented professionals who are well-versed with all the coding guidelines.
Our team ensures that most of the hassles such as documentation, coding, claim filing etc. is taken off your shoulders.
Unify Healthcare Services ensures that your claims are checked for any sort of discrepancies which could lead to denials. If somehow, a claim gets rejected, our team takes it up as a priority and resolves the issue instantly so that the claim can be resubmitted within the time frame.
Unify Healthcare Services envisions making medical billing and coding easy for all the health providers so that they can invest more time in providing better patient care.
