Best Practices to Adopt Optimized Healthcare Revenue Cycle Management



A medical practitioner must have good financial plans. Because you cannot stay financially fit without appropriate plans related to your economic development. Financial planning isn’t required to be trained as an accountant or think like a lawyer. With appropriate planning, execution and consistency, you can achieve your goals easily.

Besides providing quality care to the patients, it is the responsibility of the healthcare providers to articulate the organization’s financial goals as a tangible focus. Because healthcare facilities cannot sustain their existence for a long time period without streamlined cash flow.

Apparently, the purpose of the healthcare industry is to promote the health and wellbeing of patients. But the consistent cash flow supports the ability of medical practitioners to deliver care and services by generating income through the collection of payment.

Therefore, it is crucial for medical practitioners to adopt innovative solutions to improve relation with patients, insurance companies, as well as to streamline the medical billing services. Because the optimization of healthcare revenue cycle management is diesel associated with these factors.

An optimized RCM is crucial to the continued existence of a business. The process begins right after the patient schedules an appointment, and it goes on until healthcare providers get paid.

It isn’t just a single-step process. RCM includes the following factors that collectively contribute to its success:

  • Verification of patients’ insurance eligibility criteria.
  • Accurate Medical coding.
  • Regular Charge entry.
  • Timely Claims preparation and submission.
  • Aggressively Follow-up on claims.
  • Streamline Denial management.
  • Ensure Payment posting.

Tips to Streamlines Revenue Collections

Looking for smart solutions to activate your revenue goals? Here are the following useful tips that can help you to support your struggling medical practice.

1. Accurate Documentation

We all know the fact that successful billing starts with accurate information collection. Mostly the claims are rejected because they contain incorrect patient’s demographic information and other basic details.

A slight error in this information can lead to claim denials which ultimately slow down the revenue cycle management.

Therefore, you should hire well-experienced front desk staff. Because getting things right at the registration desk can help to keep your billing and revenue collections management optimized down the way.

Moreover, a focused professional at the front desk can make a big difference to patients as well. You should never assign these duties to a person, who is not good in communication and confused about the services you provide.

2. Accurate Coding

A medical practitioner’s compensation is highly dependent on accurate coding. Because insurance companies get information about the patient’s diagnosis, treatments, and other medical procedures through these codes.

The wrong coding not only slows down the payment collections but sometimes it could land healthcare providers into legal troubles. For instance, practitioners may face federal penalties, fines, and even imprisonment due to the upcoding, under coding etc.

Medical coding is undoubtedly a complicated and time-consuming process, which requires full-time attention. If you can’t manage this process in-house, you should outsource your billing and coding services.

Because outsourced coding experts ensure the correct transformation of medical services into standard codes. Which reduces the chances of claim denials and healthcare providers enjoy a streamlined cash flow.

3. File Claims Electronically

The orthodox methods of data collection, processing, and manual submission of claims, always leave a huge room for mistakes. In order to increase the efficiency of the claims process, you need to replace the traditional methods with electronic submission of medical claims.

It has been observed that healthcare providers get paid faster by transmitting insurance claims electronically. It can offer a number of benefits, including:

Streamlined cash flow

you can process the medical claims more quickly as compared to the paper claims. Which resulted in faster payments

Reduced costs

ou can save time and costs associated with the claims processing, mailing, resubmitting and tracking the status. As a result, you get sufficient time to spend with your patients.

Increased accuracy

The maximum reimbursements are highly dependent on the submission of error-free medical claims. Because, paper claims are often rejected or denied due to errors, or other problems.

On the other hand, electronic submission of medical claims decreases the chances of inaccuracies and optimizes the healthcare revenue cycle management. It also eliminates paperwork which decreases the chances of errors.

4. Effective Denial Management

It’s a fact that physicians lose a significant amount of their hard-earned revenue just because of inefficient claims denial management.

Therefore, you should track each and every submitted claim. In case of claim denials, you must set up a standardized process and implement best practices to decrease the denial rate.

First of all, medical billers should identify the common cause of claim denials. Then they need to rectify and appeal the denied claims in a given time frame. Eventually, the effective management of denied claims maximizes the reimbursements.

5. Consider Outsourcing

In this challenging era, the trend of outsourcing medical billing services is getting pace. Because outsourced billing experts help physicians to gain control of revenues collections management.

As it has become very challenging for healthcare providers to keep their revenue cycle management on the right track. Because the latest reforms in the healthcare industry have made medical billing and coding extremely complicated.

But by adopting the right strategies you can increase the profitability of your medical practice. Outsourced experts help you to streamline business processes while bringing you closer to the patients. Off-shore billing experts keep themselves updated with the latest evolutions in the healthcare industry. As a result, they become able to process medical claims as per industry standards.

Medical Billing Benefits is an advanced healthcare news wire. That has been providing reliable and authentic news about the latest reforms in the healthcare industry. Subscribe to our Newsletter, so you can stay aware of the current happenings in the industry.

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