Revenue cycle management, commonly referred to as RCM, can save health organizations hours of valuable time each week. RCM systems enable companies to automate and improve the myriad of processes related to collecting revenue. This means that bills are paid faster and more consistently and reduces the burden on staff members for researching and resolving issues.
Automate Provider Enrollment and Credentialing
Insurance companies have various requirements for enrolling and credentialing health care organizations and doctors. The applications can be lengthy and require substantive documentation. If information is missing or not in the proper format, an application is apt to be denied. Without proper credentials, your healthcare facility can run into issues, such as claims that are denied as out-of-network or non-participating in the providers’ programs.
Furthermore, increasing regulations and complex provider requirements require an increasingly high level of expertise. RCM healthcare can help your organization automate and track processes efficiently. An RCM company that’s experienced in enrollment and credentialing can navigate the complicated requirements and address any issues that arise, reducing the burden on your staff.
Enhance Patient Processing and Communication
RCM systems can help healthcare organizations with registering new patients, scheduling, sending reminders and detecting missing patient information. RCM software can provide easy-to-read schedules for the whole facility as well as individual doctors. Your organization can also provide clear information to patients about co-pays and other costs that their insurance might not cover.
RCM systems can also send follow-up statements, such as late notices, track change of address notifications, and handle other administrative details. You can also enable patients to pay online, which reduces the amount of paperwork to be processed by your staff.
Improve Billing Efficiency
Billing can be a complex process, especially with the varying requirements of different insurance providers. RCM software can help enable your staff to process claims electronically as well as ensure your coding and billing practices are aligned with the different provider requirements and government regulations. It can also help detect issues before claims are submitted, such as discrepancies in the contracted amount versus the billed amount for services, as well as other issues.
Reduce the Number of Denied Claims
Staff members in many healthcare organizations spend hours tracking down claims denials. Having payments tied up in denials can add weeks to the revenue cycle and tie up precious staff time for researching and resubmitting denied claims.
With RCM, you can reduce the number of claims denials by ensuring data is coded and submitted according to specific providers’ requirements. If claims are denied, an RCM system can set up a workflow to resubmit them in batches so that issues are resolved more quickly and consistently.
Decrease Accounts Receivable Time
RCM can help close gaps in the billing cycle and ensure that bills are paid more quickly. This not only provides a more stable cash flow but also means fewer days on average that your staff has to grapple with billing issues. You can also trace where issues are recurring, such as with certain categories of coding or a specific provider, which makes it easier to follow up on issues efficiently.
Provide Reporting and Analytics
With an RCM system, you can get on-demand reports of crucial information, such as scheduling, billing, the aging of accounts and reimbursements without your staff scrambling to put the information together. You can see trends and ongoing issues so that you can make informed decisions about your practice and its processes.
With the increasing complexity of healthcare practices, it’s important to consider ways to streamline processes and reduce the back-and-forth strain on your staff. By automating key processes and aligning your practices with providers’ requirements, RCM can enable your staff to spend more time focusing on patient care.