Revenue Cycle Management ( RCM ) or Medical Billing has also been a complex process to handle, the current pandemic situation and the global economic downfall have added to the complexity making it furthermore demanding and laborious. This intricate nature of the Medical Billing Process has caused an alarm to work towards a strategical method to elevate the effectiveness and ensure business standards and revenue goals are met.
Why Effective RCM is Crucial in Medical Billing?
A Medical Billing Company should have a strategical approach to handle every scope right from Patient Registration to AR Follow-ups and Denial Management involved in Revenue Cycle Process. Having the right process handling technique along with a dedicated team understanding the importance of handle each claim with the knowledge that they are the financial aspects of their end clients is the fundamental pre-requisite to handle Medical Billing as envisaged and achieve business goals. Every claim handled during the RCM process is directly associated with the business revenue, therefore effective Revenue Cycle Management is crucial in Medical Billing.
Strategies for Effective Revenue Cycle Management (RCM)
RCM being a vast and complex process to be handled, there are many areas to be consciously taken care off to ensure the claims are reimbursed fully. Any lapse or miss-handling the medical billing claims during any scope of the Revenue Cycle Process can lead to denials and loss of revenue. Listed below are few areas to be taken care of for best results
- Establish workforce collaboration by ensuring all the teams involved in handling each scope of RCM are coordinating efficiently to ensure the claims are processed as required from start till submission and payment collected
- Assign well-trained and experienced staffs skilled to understand the nuances and payor-related differences in claims processing.
- Constant refresher training to ensure the staff involved are up to date with the ongoing changes and upgrades.
- Regular audits can help capture the cause for the dip in clean claim percentage and help curb them completely
- Utilizing automated tools and software and decrease man-errors and increase efficiency
- Periodic evaluation on your process strategies and process handling method, revision on the guidelines and regulations to be followed can help stay atop and avoid denials.
- Timely claims process and submission with efforts on full reimbursement
- Effective Denial Management and AR Follow-up. Timely appealing to avoid payment delays and revenue loss
- Understanding AR processing if missed can lead to revenue loss and ensuring Old AR are worked on time and AR Aging buckets are cleared with no backlogs.
- Realize the importance of Insurance Eligibility Verification and getting Prior Authorization to avoid chances of denials.
- Timely Physician Credentialing and Re-credentialing to ensure claims are processed and reimbursements paid on time. Know that issues with Physician credentials can affect claims and payments processing
- Outsourcing RCM services to an established Medical Billing Partner who provides one-stop solution to all your billing needs
About e-care India
Ecare is an offshore-based Medical Billing Company providing complete Revenue Cycle Management Solutions for more than 2 decades. With our expertise and 1000+ staff handling Medical Billing services for 100+ Clients across the US, we can help Medical Billing reduces their operational cost and increase revenue flow. Our strategical approach leads to maximized collections and minimizes lost reimbursement and denials. To know more about e-care and our services call 813-666-0028 or log on to www.ecareindia.com