An ongoing challenge for all hospitals, revenue cycle management requires the use of technology to keep track of claims and address issues as and when they arise. It is fairly common for claims to be denied, denial management being an industry wide challenge. Efforts by healthcare facilities have not made much impact in the reduction of claim denials.
The passion to cure people of ailments is what drives a person to become a physician. However, just medically treating people is no longer the only work that a physician needs to do – there are so many other things that demand his attention on a regular basis. Juggling between treating patients and running a practice often brings in many challenges that need to be faced on a daily basis.
Medical practices have been leaking money for some time now – increasing expenses, shrinking insurance reimbursements, and increased compliance parameters means more paperwork than ‘actual’ work. Relying on practice managers to help cut down your expenses could prove tricky if not done right, then there are efficiency and technology challenges that have been plaguing a number of practices.
Revenue Cycle Management is the process of managing your claims processing, payment and revenue generation. This includes everything from determining the patient’s eligibility, collecting their co-pay, coding the claims, tracking the claims, collecting payments and following up on denied claims. A critical part of your office function, it is important that the entire revenue cycle process is managed efficiently.
As we come to the end of another year, it is good to look back and reflect on the highlights of the year – the good, bad and the ugly. Understanding what could have been avoided; done in a better way and what was just perfect, is a great way to build on your new year resolutions.
If you look at your patient’s problem holistically, why would you not do so with your revenue cycle problems too? Similar to the human body, where different organs work in tandem to keep the body healthy; in revenue cycle management different parties come together to keep the cycle healthy. These would include the patient,
Revenue cycle is defined by the Healthcare Financial Management Association as “All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” The term includes the entire tenure of a patient account – from its creation to the payment. The process of revenue cycle flows into and affects each component of the system.
Technology is a two way sword – adopting the correct technology will reap you good rewards and high profits; however, choosing the wrong technology will bring down your efficiency and prove costly. Selecting an Electronic Health Record system is a critical decision as it is a big investment for hospitals. According to a recent survey by Software Advice,
The Healthcare Industry has always been on top of the game when it comes to technological advancements and usage. Computers, ECG machines, even artificial intelligence has been integrated with leading US hospitals. However, most of these advancements have been in the core medical practices.
It is universally known that American Healthcare has one of the most complex billing systems.
The healthcare industry is bracing itself for probable disruptions that the latest version of International Classification of Diseases will bring with its new set of codes for describing illnesses and injuries.
Under ICD-10, cardiologists will have 845 codes for angioplasty, dermatologists will need to be specific regarding which of eight kinds of acne a patient has,