To provide the best possible healthcare to your patients, it is important that your healthcare providers are up to the task. But, how can you ensure that the healthcare providers you hire are competent and qualified for the job. Provider credentialing is the best way to compare, evaluate and verify the qualifications and competency of the healthcare providers that you are hiring.
Understanding net collection rates will help you to gain a better understanding of how much money that is owed to your practice is collected. Calculating your collection rate is quite simple, but it offers an excellent understanding of where your business stands and how you can improve it through medical billing operations.
Calculating your Net Collection Rate
The net collection rate holds a barometer to the health of your medical practice.
Revenue cycle management (RCM) refers to the financial process of keeping track of a patient’s expenses during their stay at the healthcare facility. The health care facility employs the use of advanced billing software to manage the entirety of the billing, right from the registration of a patient to the final payment, in an effective manner.
The process of physician credentialing is an important task that a health care institution has to undertake when hiring a new doctor. It is essentially a process that entails verifying a physician’s credibility, licensure and making extensive back ground checks for any criminal and financial misgivings in the past. This preventive measure will help eliminate any potential problems that might crop up in the future because of the new doctor,
A successful medical practice can flourish only when it is doing well financially. Incorporating robust billing practices and ensuring the adherence to updated medical billing codes is thus of paramount importance. Revenue Cycle Management (RCM) is a process that oversees all your health care facility billing in order to ensure that your revenue generation is at optimal levels.
Your credentialing process needs to start well in advance if you are planning to start your own practice or bring in new doctors to your existing practice. It is important to understand how credentialing can make a significant difference to the pace of your cash flows and how smooth your practice runs. Ignoring the credentialing process will result in delayed cash flows,
Revenue cycle management throws up tons of data for tracking. However, not everything requires regular tracking and measuring. While it is important to look at all the data derived from the system periodically, it is very important to track and measure some key metrics regularly. Measuring the key metrics against the industry standard is a good way to determine where your processes require improvement.
Physicians educate and train themselves to practice medicine and impart health care to the populace. However, a large part of their daily lives is spent tending to administrative tasks – something that they would rather not be doing given half a chance. With the constantly evolving medical regulatory and payment space, it is very difficult for physicians to escape from the requirements of administrative tasks.
Healthcare revenue cycle management has undergone a radical and drastic change in the last decade. From days when most patients had $20 or so as co-payments and insurance companies paid claims in full, to today, when the physician first needs to consider medical necessity before ordering a lab test – things have certainly become more complex and challenging.
Starting August 1, 2016, the penalties under the False Claims Act (FCA) along with the Anti-Kickback Act, The Program Fraud Civil Remedies Act and a host of other Acts have nearly doubled to a minimum of $ 10,781 and a maximum of $ 21,563. A result of the interim final rule issued by the Department of Justice,