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. RCM strikes a healthy balance by recording patient details with the treatment they are being received, which eases the process of your institution in filing for insurance.
A reliable healthcare revenue cycle management is the first step in setting up a reliable revenue system that assures growth. Even employing simple measures to track a claim can help you immensely in extrapolating your revenue cycle thus, enabling you to make major financial decisions on the go.
The revenue cycle begins from the time your patient checks in, and every treatment and services offered to the patient is meticulously recorded, until it is time for the patient to be discharged. This bulk of information is then transferred to the billing department- either in house or an external body to whom you have outsourced.
This billing department then segregates the services and procedures into necessary sectors, and are then recorded using the right codes that represents each procedure. Once the data has been processed, it is then sent for claims submission to the necessary insurance companies.
Correspondence with insurance companies
Getting in touch with health insurance companies and file for claims is an integral part of the RCM. The insurance information of the patient is recorded the moment the patient steps into the physician’s office. This information is then used to file for claims for the treatment provided and the procedures performed.
It is the job of the RCM to record the treatments under the listed categories in accordance with the ICS-10 coding guidelines. The insurance company then sends across the data of which of these treatments are covered by the insurance, and the remaining will be billed to the patient.
A reliable RCM in place can help reduce the time between providing a service and getting paid for it. RCM service can also effectively reduce the number of denied claims, since they adhere to all the necessary guidelines and are up to date with the latest billing parameters.
Although a majority of the payments are made through the insurance companies, some patients do opt to pay for the treatment out of their own pockets. Besides, the insurance might not cover the entirety of the treatment, thus your patients will have to partially pay for the procedures with their own money. These post insurance balances can actually eat into the hospital revenue if they are not taken care of at the earliest. Adjusting your client’s individual contracts/ fee schedules and following up on the claims is an important aspect of the claims department. This will ensure that you run a profitable enterprise where revenue generation is made easy.
At MedConverge, we have a slew of resourceful and experienced staff who offer world class billing services, ensuring that your claims are always done efficiently and on time. You no longer have to worry about your claims and reimbursements when you hire our services. For more information on our billing services, write to us at firstname.lastname@example.org or call us on (800) 898-0709.
- Belliveau, J. (2017). What Is Healthcare Revenue Cycle Management? Retrieved January 27, 201, from www.revcycleintelligence.com: http://revcycleintelligence.com/features/what-is-healthcare-revenue-cycle-management
- Revenue Cycle Management 101. (2017). Retrieved January 27, 2017, from www.nuemd.com: http://www.nuemd.com/revenue-cycle-management/rcm-101
- Rouse, M. (201). revenue cycle management (RCM). Retrieved January 27, 2017, from www.searchhealthit.techtarget.com: http://searchhealthit.techtarget.com/definition/revenue-cycle-management-RCM