Revenue Cycle Management (RCM) services are often overlooked by healthcare providers, but they are a valuable asset for a successful practice. Revenue Cycle Management is a term that describes the processes by which your organization collects its revenue from patients and insurance companies. RCM services are helpful for reducing debt, improving cash flow, and reducing administrative costs at your practice.
Below are a few essential RCM services to improve your practice
Eligibility verification is the process of ensuring a patient is eligible for benefits under their insurance plan. The RCM team can also check for disability coverage if it applies. RCM services can help you verify patient eligibility by checking benefit plans against your billing codes and procedures. This helps reduce the amount of denied claims and ultimately improves your cash flow.
2. CLAIMS SUBMISSION:
Claims submission is the process of submitting claims after services have been rendered. The RCM team ensures that the claim is submitted as cleanly as possible prior to submission to help maximize reimbursement potential.
3. TIMELY CLAIMS PROCESSING:
RCM services streamline payments by automating the submission process with electronic claim submissions and follow-ups via fax or mail if needed in a timely manner. This improves cash flow with quicker and more accurate claims.
Timely claims processing is imperative to receive the maximum reimbursement. If your claims are submitted too late, insurance companies may deny them causing your practice to resubmit it at a higher cost.
4. CODE AUDITING:
Code auditing validates medical codes against procedure documentation to determine accurate reimbursement levels from payers such as Medicare, Medicaid, commercial carriers, and workers’ compensation companies.
RCM service providers offer code validation solutions designed specifically around healthcare workflow processes. Often, they can provide real-time updates on risks involved with each provider and/or their staff. An audit could be required for a variety of reasons such as:
- Accreditation survey
- Medicare compliance review
- Third-party payer contract negotiations
- Revenue cycle improvement initiative
RCM services can support a code audit by providing expert resources; this helps ensure your practice is billing for procedures accurately and maximizing reimbursement levels.
5. PAYMENT POSTING:
Payment posting accurately tracks your revenue and expenses by submitting payments from patients and insurance companies to the correct accounts within your practice’s accounting system. RCM services automate payment posting so it is completed quickly and efficiently. Automating this process keeps your practice’s financial data accurate and up to date.
6. DENIAL MANGEMENT:
Denial management is the process of following up on unpaid or denied claims. RCM services can help your practice track claim status, prepare appeals, and negotiate with insurance companies. This decreases the amount of lost revenue within your practice.
The collections process consists of pursuing collections from patients who have received care but have not yet paid their bills This can be a daunting task. RCM services track patient balances and contact those patients who are overdue on their payments. This helps reduce bad debt for your practice and improve your cash flow.
Outsourcing these RCM services can help improve your cash flow, automate administrative tasks, and keep your practice compliant with insurance companies, Medicare/Medicaid guidelines, and more. Investing in a robust RCM service is vital to the success of any healthcare organization.
iPatientCare is one of the top healthcare Revenue Cycle Management services providers in the United States. Our team manages all aspects of provider billing. From claim submission to denial management, our healthcare RCM services experts know the importance of a seamless revenue cycle.
Contact our Revenue Cycle Management experts today to learn more about how iPatientCare can benefit your practice.