Clinics in rural communities struggle with declining reimbursements. Ensuring financial sustainability and profitability by improving billing processes and managing denials are top priority. Outsourcing Revenue Cycle Management (RCM) can help rural clinics capture every dollar and seek higher reimbursement.
Knowing the financial challenges within rural healthcare setting, here are four RCM myths we commonly see impacting revenue.
Myth 1: Patients don’t contribute much to the payer mix
With the increasing financial responsibility of healthcare costs, patients are now the third-largest payer in the country. A large portion of the rural population is more likely to be uninsured (particularly in states that did not expand Medicaid). Therefore, rural clinics and healthcare facilities need to provide accurate clinical estimations and upfront fee collections before delivering care. Since patients are becoming more aware of their healthcare costs, price transparency is becoming increasingly important. Providing upfront clinical estimations at the point of service or procedure can help improve healthcare bills and reduce bad debt and write-offs.
Myth 2: Patient engagement has nothing to do with revenue
Patient engagement involves more than simply talking to patients or sending them emails and messages. Patient engagement encompasses everything from patient management to revenue management. Using clinical facilities can reduce missed appointments with appointment reminders, deploy CCM programs for reimbursement by CMS, receive payments electronically using patient portals. Patient engagement helps providers administer better care delivery, which drives the revenue.
Myth 3: Telehealth doesn’t pay off
Medicare and Medicaid have made it easy for clinicians to find lists of covered telehealth services by CPT code and reimbursement guidelines on their web portals. The reimbursement for telehealth is the same as that of a face-to-face visit, although some commercial payers may differ. Most importantly clinicians need to have eligibility and proper credentialing with payers and be licensed in the state(s) they expect to treat patients. Providing telehealth not only drives new revenue streams to the rural clinic, but also provides a more convenient care delivery method for patients who need it most.
Myth 4: Outsourcing in RCM technology is a dead investment
This is not the case. Rural clinics and hospitals can get full reimbursements of their revenue by outsourcing their complete RCM process. With today’s technology, it is much easier for hospital back offices to keep track of key performance indicators such as accounts receivable, claims filed, and EDI rejection rates. By integrating finances with patient portals that offer electronic payment options, sending electronic statements and automated reminders to patients, and enabling patients to pre-pay for the services, back offices can ensure everything that their RCM partner needs. All of this resultss in stronger reimbursement and strengthening of cash flow that makes ROI on the technology and services investment measurable.
Rural hospital facilities have led and will continue to lead their communities with resilience, innovation, and collaborative partnerships. We believe that experienced healthcare leaders understand their requirements for success. We embrace the truth of today’s rural, patient, and RCM landscapes.
iPatientCare, is a leading provider in transforming RCM services with FREE Cloud-based Meaningful Use Stage-3 certified EHR and PMS technology. It provides efficient, responsive, and accountable billing implementation and back-office services that give more than 98% first-pass claims submission and efficient AR follow-up, denial management at very competitive rates. To learn more visit iPatientCare’s Healthcare Revenue Cycle Management.