Healthcare reforms and regulations have been one of the prime reasons for motivating change in the Accounts receivable workflow process which can help boost the Revenue Cycle. It is a well-known fact that the medical Billing Practices is known to affect the financial performance of most healthcare providers.
Simply stated, Revenue Cycle management (RCM) is the process that manages claims processing, payment and revenue generation, and is now pushing towards the use of technology to keep track of the claims process at every check point. In 3 very simple steps you can fast track this process to up your revenues adding to a good ROI on your RCM.
1. Automate & Digitalize:
According to a recent study, manual paper-based steps required to address a denial claim take up more than 90 percent of the process and requires human investment operations. This is a waste of man hours and involves high risk in terms of fraud detection and prevention. Automation can lead to reductions in manual processes by at least 75 percent, thus potentially creating a quick and more efficient processing of claims. This also includes automating front-end office services like appointment scheduling and insurance eligibility verification; tasks related to clinical care like coding and charge capture; and back office tasks like claims submission, payment posting, statement processing and the management of denied claims. The more quickly and efficiently these tasks are handled, directly impacts revenue settlement.
2. Initiate an Effective Claims Management Process:
This involves not just an understanding of how to negotiate payer contracts, but also expert knowledge on the complexity of how insurance companies work, applying the correct codes with respect to the new updated ICD-10 coding system, and timely filing of applications and handling of rejected claims. Claims reimbursements from payers comprise the major share of the revenue Cycle management. It is thus crucial to have speed and efficiency in your practice to turn claims into cash to increase your healthcare revenues. Either training in-house teams or outsourcing this segment of the process is very vital to a thriving Revenue Cycle Management.
3. Patient centric:
This is the most vital and crucial segment that can help increase the revenues, if cash-strapped. Patient revenue comes from patient self pay, including co-pays, and deductibles. According to the Centers for Medicare and Medicaid (CMS), and based on a recent poll, the total share that is the patient’s responsibility has shown an increase in recent years, up by 23 percent, and this trend has been estimated to continue towards a more consumer-directed healthcare product driven segment, decreased insurance coverage, and a higher overall deductible. Moreover, with the introduction of the Obamacare or Affordable Care Act (ACA) and the new kind of payment models that have been introduced based on the Value Performance based models, healthcare providers will need to step up their attention on patients rather than on administrative tasks, best left to the in-house or outsourced experts. Focus on patients’ problems will bring in more footfalls and thus attract a higher revenue.