The way you manage your revenue cycle reveals a lot about your approach to your business and your prospects of success. That is true across industries. The revenue cycle, in general, refers to a business’s wheel of equilibrium between income and expenditure. However, revenue cycle management in the healthcare industry is a very different ball game; it is far more sophisticate and strained than in any other industry.
Every healthcare practitioner is constantly looking for ways to improve their practice’s healthcare revenue cycle management companies. The essential structure of the revenue cycle remains the same whether small practices at the entry level or large institutions with several departments offering patient care. The two main components that drive the entire process are time and workflow efficiency.
The healthcare revenue cycle is a multidimensional entity ruled by three pivots: the patient, the provider, and the insurance company. Every step of the revenue cycle is critical to its success, from patients contacting the facility to inquire about treatment to the collection of the balance payment from the patient following insurance reimbursement. This is why one should always be on the lookout for potential problems in the process and keep themselves updated.
Improving Data Capture at the Front Desk
One option to improve healthcare revenue cycle management is to give the front desk at your facility the functionality to execute some critical billing-related duties. This can be accomplish by training your employees to do the following:
Patient registration accuracy
The information gathered from the patient, whether via phone call, online booking platforms, or at the front desk of your clinic, should be complete and error-free. From a billing standpoint, every detail important, including the precise spelling of the patient’s first and surname name, current postal address, and other details.
Verification of eligibility and benefits
Make certain that the patient’s insurance information is double-checked. Examine its validity status, changes in packages since the last visit, who is insured, and geographic changes. Using this information, one can confirm whether the treatment is cover by the current plan and educate the patient on their benefits. If the patient is determined to be ineligible for the planned therapy under their policy package, the staff can advise them on alternative treatment alternatives and payment methods. One of the fundamental steps that Bellmedex has incorporated into its client’s process is the verification of eligibility.
This year’s competition for top claims management vendor was fierce. KLAS ultimately awarded the award to Quadax for its Xpeditor solution, which received an overall score of 91.1 points. According to the survey, 97 percent of users polled stated the claims management solution is part of their long-term objectives and that they would purchase it again.
The clinic’s front-end employees can begin their revenue cycle activities by preauthorizing the patient to secure compensation before treatment. This provides some assurance that you will be paid for the quality of treatment you provide. The patient can also relax regarding their looming liabilities. It is a win-win situation for both parties. Bellmedex also ensures that the patient receives an early beneficiary notice if the insurer does not cover the medical charges.
Manually Performed Tasks Automation
Practices can improve their revenue cycle management by employing cutting-edge practice management software. Using an integrated software interface to store and manipulate clinical data was uncommon until recently. But it’s now the new normal.
Appointment scheduling and patient reminders are automated
With an automated approach, all of your front desk’s communication with patients is done better and faster. Patients can quickly pick a convenient appointment and enter their information on an online platform. Gone are the days when the patient or your staff had to write down every piece of information on paper, which was prone to human mistake. Many claims were formerly reject owing to a missing digit in the policy number or an inaccuracy in the date of visit, however this is no longer the case. Automated patient reminders can also be program to guarantee that the patient arrives at the clinic on the planned date and time, reducing the workload on your team. Rearranging appointments and following up.
The card-on-file method
One effective revenue cycle management best practice is saving the patient’s credit card information in their electronic file at the moment of registration. Later, if there are any unpaid patient liabilities after insurance payment, they can given the option of paying with this card. This reduces the need for patients to return for payments on many occasions.
Data management system in the cloud
The innovative cloud-based documentation system facilitates access and integration of front-end to back-end processes. Every detail entered is responsible and easily changed to meet other documents in the revenue cycle, such as billing invoices and claims. This saves time by avoiding the need to enter the same information for different documents.
Claim generators that work automatically
Installing billing software simplifies claim processing more than ever before. It can produce electronic claims by analyzing diagnostic and treatment codes. Because insurance companies are increasingly accepting electronic claims submissions, it is important to have claim generator software that is tailor to the payer’s specifications. You benefit from the deployment of cutting-edge practice management software with Bellmedex’ practice management solutions, which assists you in automating the process for ease and accuracy.
Medical Transcription and Coding Practices Have Improved
Error-free, thorough electronic health records are a basic requirement for validating your claims about the treatment you received. No dates, names, authorizations, or patient visit details should left out of your transcription process. Similarly, the coding procedure should be Carrie out by experts who can examine the records and reliably elicit each capable event. Every incorrect code, missing code, or incomplete data disrupts the charge capture process, leaving you with no money for the valuable service performed.
Compliance education for employees
The state and insurance firms are constantly altering their requirements, making compliance with basic regulations a major burden. Arrange for periodic training and updating your personnel on the latest coding techniques as a vital revenue cycle management action plan.
Audit of coding and billing
Scheduled audits at your hospital can help you improve healthcare revenue cycle management. It can done internally by an auditing team or by hiring external auditing services. Examine all of your billing cycles, payment policies, and billing processes for compliance and revenue loss. This assists you in discovering fraud, HIPAA-related issues, and coding difficulties before they become legal risks.
Claims tracking and denial management
All of your revenue cycle tactics should aim for speedier insurance reimbursements. The necessity of creating ‘clean claims’ to improve healthcare revenue cycle management cannot be overstated. Do the following to generate ‘clean claims’:
Scrub claims thoroughly before submitting them
Send the claim to a clearinghouse or utilize clean scrubbing software to check for errors and omissions that could lead to denial. The complete patient, provider, insurance, and coding documentation must be scrubbed for discrepancies in reported facts. It ensures that the information in your health records validates your request for reimbursement and assists you in submitting a full proof claim for faster approval; one method for improving healthcare revenue cycle management.
Management of denials and the appeals procedure
Even after you have perfected your claims, insurance companies frequently deny or reject payment requests. Maintain track of the status of your claim request and be ready for the appeals and resubmission of claims. The earlier you can convert denied claims to approval worthy claims, the better your account receivables will be.
Improving Healthcare Revenue Cycle Management by Outsourcing RCM Services
This is the most effective way for increasing your income cycle. Leaving administrative tasks to specialists relieves you of managing responsibilities and allows you to focus on patient care. Pre-authorizations, clinical documentation, coding, bill capture, claim creation, and denial management are all tasks that practice management outsourcing businesses may simplify and streamline to achieve the best results. It’s like having a compliance manager in the house to troubleshoot data capture concerns.
Outsourcing can improve the quality of your process and assist your personnel in fine-tuning it to higher standards. Adding experienced people, cutting-edge technology, and other resources to your practice boosts profitability. Take advantage of faster response times without jeopardizing HIPAA requirements or privacy rights.
RCM outsourcing providers, such as Bellmedex, may develop the process in cost-effective packages that are tailor to the demands of your practice. They are outfit with cutting-edge practice management software that can do wonders for your business. The clever statistical key performance indicator, which may help you look at each step of your practice objectively, is one of the features of Bellmedex. It is easy to analyses process gaps with the help of easily understandable graphs and diagrammatic reports. It can provide you with useful advice on how to improve healthcare revenue cycle management in order to generate more revenue.
The methods listed above are a few promising approaches to improving healthcare revenue cycle management at your facility. Bellmedex, with extensive experience in the healthcare field, can assist you in shortening your revenue cycle, resulting in greater revenue, personal growth, and clients for your company and team. Join forces with the Bellmedex professionals to strike a balance between running a successful practice and becoming the best in your area.