Ways to Improve the Revenue Cycle Management for Your Healthcare Business

Revenue cycle management is one of the established ways to determine your approach to the business and calculate the chances of being successful at what you do. This stands true for all businesses, and the healthcare industry is no exception. 

The revenue cycle is the wheel of balance between expenditure and revenue. But, when it comes to revenue cycle management, the healthcare sector has a different ball game altogether- much more outstretched and equally complex.

Every practice and every provider is on an endless quest to improve their medical revenue cycle management. Big or small practices providing patient care have a similar revenue cycle at the core. Driven by time and efficiency, the revenue cycle management of the healthcare industry is still a multifaceted entity, with insurance companies, providers, and patients pivoting the process.

Every step is decisive, from when the patient contacts a practice for a service to collecting the balance amount after insurance reimbursement. That is why it is paramount for practices to look out constantly. That helps avoid the pitfalls and stay updated to stand financially tall.

Here are some tips to help practices improve their existing revenue cycle management.

1. Strengthen the data capture at your front desk

The front desk is the face of your practice. There is no exaggeration that the same holds for the RCM cycle in medical billing. Empowering the front desk at your practice can revitalize its functionality. This will put your practice in a better position to perform essential tasks that expedite the efficient billing process.

• Accurate patient registration

The information collected from the patient, either through a phone call, online booking platforms, or at the front desk of your practice, should be complete and error-free. From a billing standpoint, every detail matters, including the correct spelling of the patient’s first and last name, current mailing address, and other demographics.

• Efficient eligibility verification

Double-check the patient’s insurance information. Examine the validity status, changes in benefit bundles since the last visit, which is covered by the insurance, and location changes. Using this information, your practice can confirm whether the treatment is covered by the existing plan, and you can educate the patient about their benefits. 

If the patient is ineligible for the proposed treatment under their policy package, the staff can advise on alternative treatment options and payment methods. One of the core processes that Capline Healthcare Management has incorporated into its clients’ processes is the verification of eligibility.

• Preauthorization

The front-end staff of your practice can begin their revenue cycle operations by preauthorizing the patient to confirm reimbursement before the actual treatment.   This assures you that you will be paid for the quality of care you provide. The patient can also relax about their looming liabilities. It is a win-win situation for both parties.

2. Automate manual tasks

It is time to up the game by implementing the latest practice management software. This will help you improve the revenue cycle at a basic level. Each integrated software available in the market is powered to store and manipulate practice data to make the most of it.

• Automate scheduling and reminders

With an automated process in place, all of your communication with patients is done better and faster. Patients can easily find a convenient appointment and put in their information on an online platform. Gone are the days when the patient or your staff had to write down every piece of information on paper, which was prone to human error. 

Many claims were previously rejected due to a missing numeral in the policy number or an error in the date of visit, but this is no longer the case. Automated patient reminders can also be set to ensure that the patient arrives at the clinic on the scheduled date and time, reducing the workload on your staff. Rescheduling appointments and following up has never been this more accessible.

3. Improved Scribe services

Scribes are trained and focused on converting the patient encounter into a high-quality structured document. Scribes are known to achieve higher coding levels than physicians. There are several reasons for this. First, the physician usually charts at the end of a long day. 

Providers are not big fans of charting and usually document to the bare minimum. Many physicians chart quickly, attempting to recall each visit and chart as little as possible so they can simply go home, eat dinner, and spend time with their families. 

This charting method makes it easy to forget to remind patients of upcoming preventative tests or procedures, which can impact patient care and lead to missed reimbursement opportunities. All of this is systematically and productively enhanced by the utilization of scribes.

4. Efficient Denial management

Insurance companies frequently deny or reject payment requests even after you have perfected your claims. Therefore, maintain track of your claim request status and be ready for the appeals and resubmission of claims. The faster you can convert denied to approval-worthy claims; the better your account receivables will be.

Outsource RCM

This is the best-proven method to improve your revenue cycle management in medical billing. In addition, leaving the administrative work to professionals spares you from managerial roles and helps you to focus on patient care. 

Be it pre-authorizations, clinical documentation, coding, bill capture, claim generation, or denial management—practice management outsourcing companies can optimize and streamline your workflow to obtain the best results. It is like having a compliance manager in the house to resolve the issues in your data capture.

Outsourcing your RCM needs to Capline Healthcare Management can improve the quality of your process and assist your staff in fine-tuning it to higher standards. Adding experienced professionals, cutting-edge technology, and other resources to your practice boosts profitability. Take advantage of faster turnaround times without jeopardizing HIPAA standards or privacy rights.