The Healthcare Financial Management Association (HFMA) defines revenue cycle as "All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue." In other words, 'Revenue Cycle Management (RCM)' is the process of the creation of a patient's payment account to the actual payment. A practice can be successful only if all the major components related to your billing services are in place. Excellent skills and practices are required to tackle medical billing issues.
Services can be improved in the long term by enhancing a few parameters:
1. Financial performance and reporting:
Improve your cash flow with detailed reporting systems and quick turnaround times. Claims if denied, need to be corrected and resubmitted at the earliest. Allowance of electronic transfer of funds and payment posting will enhance the financial performance of the medical billing services. Include conciliation reports in your system to manage daily transactions.
2. Billing practice and back office activities:
As billing and payments take time for processing, ensure that claims are submitted on time and quickly. It is also required that processes are monitored at regular intervals and new strategies are invented regularly for scaling up the services. Gather as much data as possible with precision the first time the patient reaches the hospital. It allows for a hassle free dealing at the next visit of the patient.
3. System flexibility:
Have all the information on a spreadsheet ready so when a patient calls, accessibility and accuracy to the information is quick. Ensure that an automated claim filing system is in place so as to accelerate reimbursements. Have a system which can indicate unpaid claims of 30, 60, 90 and 120 to reduce the outstanding payments Ascertain that the system supports formats ANSI 837 and CMS 1500.
4. Efficient technology:
It is important to be up to date with the scheduling software and the billing applications. Make it a one stop integrated solution which allows auto posting of insurance payments from practice management software. Maintain all compliances. Make certain of a follow up on A/Rs. Make the system web-based and accessible 24/7 to allow accessibility to information anytime along with the ability to pull reports or invoices.
5. CCOF:
Implementation of the process of signing the 'Credit Card Authorization Form' ensures the elimination of A/Rs and recapturing the out-of-pocket (OOP) expenses. This safely secures credit card details and makes things hassle free for patients as it avoids them from calling the clinic to make payments. In addition, it increases overall customer satisfaction.
Medical billing and coding is not straightforward. Complete RCM services for any specialty empower medical practitioners to acquire every dollar, thereby improving cash flow. This also aids in reducing administrative burdens thereby allowing the physician to focus on complete patient care.