Revenue Cycle Management (RCM) is an end-to-end process beginning at the time of claims submission and ending with final payment. In addition to managing medical billing and coding, RCM aims to identify revenue leakage points and correct them. With a streamlined workflow and focused attention on achieving revenue goals, your practice can reduce inefficiencies and eliminate gaps to significantly cut down on delays and loss of revenue.
RCM is a comprehensive process that requires a specific skill set and bandwidth for handling various scopes of services at different levels by different staff. Efficiency and effectiveness are key determinants to process quality claims and improve revenue flow.
The RCM process can be classified into three key segments for self-assessment:
- Personnel
- Do you measure the quality and productivity of your team?
- Does your staff provide comprehensive demographic, insurance, and clinical documentation to support accurate billing?
- Process
- Are procedures in place for workflow documentation?
- Does your billing team have a smooth, effective process for claims submission and payment posting, including reviewing errors and denials?
- Tools & Technology
- Have you implemented up-to-date and effective tools and technology for your practice, such as an Electronic Health Record and Practice Management System?
Improve your practice’s revenue cycle with these four steps:
- Perform Regular Claim Audits
Unfortunately, claims denials are unavoidable. However, they can be reduced by having checkpoints in place at each step along the life cycle of the claim. This can help identify the reason(s) for repetitive errors so your team can determine patterns for errors and work to fix them.
- Reduce Batch Size to Achieve Higher Efficiency
The volume of claims at each stage affects the efficiency of the RCM process. Using the smallest batch size per day may achieve higher efficiency and process claims in a shorter time frame. Smaller batch sizes might also allow the billing team to have more visibility into potential errors and may improve efficiency in fixing them.
- Utilize monthly reports
As a business entity, it is crucial to monitor your growth trends, loopholes, percentage of submitted claims, and paid and denied claims. Conducting a monthly review of paid claims against the claim volume affords a clear indicator of efficient Revenue Cycle Management. Your Practice Management System should have a robust reporting library to help provide insights into areas of improvement and current revenue status.
- Partner with an Experienced Billing Service
To reduce financial stress, outsourcing your RCM to a billing partner may be the best solution for your practice. iPatientCare’s Revenue Cycle Management team can manage the entire billing cycle from start to finish.
Efficient Revenue Cycle Management is key to successful revenue generation. With a qualified workforce, checkpoints at each stage of the claim processing, and regular audits, you can build an efficient and effective Revenue Cycle Management process for your practice. If you are interested in partnering with iPatientCare’s advanced RCM solutions, contact our experts today.
