ELIMINATING INADEQUACIES IN REVENUE CYCLE MANAGEMENT

Category: Health

Inadequacies often get un-noticed even when you try to create fool proof policies and procedures in your Revenue Cycle Management. Like we discussed in one of our previous articles, Revenue Cycle is a Chain of Events, an inadequate procedure in one stage of the RCM & Billing process will hamper the entire process that follows. These may not appear to you on the face of it as you have built the system and you might tend to over look the problem. In some cases you wouldn't even know that a problem exists until a third person reviews it thoroughly. Medical Billing Companies can play an important role in identifying inadequacies in your Revenue Cycle Management (RCM Services), Billing and Medical Coding process. Firstly it is important keep your records intact. By records, we mean everything right from Patient Insurance ID all the way to Medical Records and Claims. This will itself solve half the problem in Revenue Cycle Management. This indicates that you need to collect correct information from the patient, perform eligibility or authorization accurately, use accurate billing codes, capture accurate information in the claim forms before you bill the insurance. You can collect what you deserve only if you right all the time, that is right in all the steps of Revenue Cycle. A thorough audit of all the processes can be one strategy. However this take a lot of bandwidth and also increases your cost of realization. So, here are few other measures you can put in place to do it right at a very less cost of realization and in turn generate more profits. Automate the Process: Try to get out of manual way of doing things and automate processes that are repetitive in nature. This will straight away eliminate all human errors as long as your system is working fine. Automation tools also helps you put check and balances within the system that can alert if something is not right. Accurate Coding: Bill only those services that are provided and are evident in you medical records. Remember, medical records must always substantiate what you bill. Also make sure what you bill is covered in patient insurance coverage. Denials caused due to coding errors or improper medical records form a considerable part of the overall denials. You can also look at having an Experienced Medical Coding Company do this activity for you. Promantra has over 14 years of experience in Medical Coding and have a large list of happy clients. Being More Organized: This will take you a long way. You need to stay up to date with your current AR, Rejections and Denial Management and perform timely AR Follow-up with the payor. We have seen most of companies accepting what they get paid but do not put an additional effort to get accurately paid. In some case, they wouldn't even know if they got underpaid. In some cases they just don't have enough time to run around each underpaid or unpaid claim. They just move on. This is just resulting in a great loss of revenue. Being more organized with the currently available resource can take you far ahead. Promantra has been listed as one of the Top 10 Most Promising Revenue Cycle Management Service Providers and has been delivering and exceeding client's expectations. Take to one of our experts today in case you have challenges in your RCM. Give us the Challenge.