In our previous blogs, we have written about how to reduce A/R denials & rejections, behind the scene facts of medical billing, how there are no grey areas in medical billing, and what you need to look for when outsourcing any particular component of the Revenue Cycle Management (RCM) process.
We are aware of the RCM process which starts from the front desk scheduling & appointment, through patient demographics, payment posting, Account Receivables (A/R), appeals against denials & rejection claims & physician credentialing- and how all this translates into the earning revenue of the healthcare business.
The stringent rules and regulations that are changing the face of the healthcare business from being paperless to a digital world in order to bring in transparency, reduce Medicare costs, and push for better healthcare services, are slowly increasing the operational and administrative costs of the healthcare providers. Despite the need to focus on patient’s health via the Value-based Performance fee, healthcare providers are struggling to keep the Revenue Cycle Management well-oiled, but at the cost of their reimbursements and fear that outsourcing could spell further loss.
However, healthcare providers need to be aware that outsourcing is not a necessary evil, but even if a small component can be outsourced, depending on the size of the practice, the resources can then be better utilized to focus on the core practice- patient’s health and wellbeing.
At MBC, we provide for not just the big picture in healthcare but have staff trained for every component of the Revenue Cycle Management process, as well as staff to handle the smallest of units for the medical services- like medical coding, medical billing, specialty billing, and transcription.
A glimpse of our facts and figures themselves will speak volumes of the emphasis we place on customization and quality;
Accounts Receivable (A/R):
This forms the core of the Revenue Cycle Management Process and is the lifeline for generating revenue. Our billers organize the A/R timeline-wise (AR days between 30 to 45 days, 45 days to 60 days, and beyond 60 days) and work on critical claims first. They keep the average age of accounts receivable at 25 days or less. And MBC also handles hospital billing, where more often than not AR generally runs into 120 days, which is highly detrimental to RCM.
The less number of days for processing appeals = faster cash flow = enhanced revenues
Denials & Appeals:
This is the most crucial component that can make or break your Revenue Cycle. It’s our ANALYSIS that primarily keeps your claims from being rejected or denied. If a few do slip through, then prioritizing both for volume and dollar value, appeals are filed accordingly in a timely manner. Appeals are costly, and our billers are aware of this, also knowing that many claims is not even appealed for- which translates into thousands of dollars going waste.
Electronic Process:
Our billers are well versed with the electronic process that has been initiated via Medicare. Based on your requirements, MBC’s medical billers not only suggest the appropriate software but can initiate the workflow from day 1- no loss of days or hours thereby wastage is conserved and the benefits are accrued from day 1. Integrating the EHR/EMR and seamlessly working the workflow, is what our billers do the best with the minimum of errors
Reporting:
The healthcare departments like Medicare now demand a lot of reporting which needs to be done online and electronically. Our billers are well known to not just compile but present the reports required that also diagnose the health of your practice- via the Accounts Receivable report, the KPI (help you identify which encounters and CPT codes are the most profitable for your practice); Insurance carrier Reports (tracks payments, collections, and CPT codes and units, & information that can be employed to negotiate better pricing with payers and insurance companies)
The Reporting helps analyze the gaps, loopholes, what is missing, where we need to focus more, etc. This is what most vendors lack in delivery. Improvement is the hallmark towards working for quality and this can come in only when billing vendors step up and analyze how the workflows and processes are working. At MBC, we take pride in giving the best, which makes us stand apart from the rest of the “Bill Mills”, after all, if we derive the best for you, then it’s a win-win for both!
