How does Revenue Cycle Management affect practice’s reimbursements?
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How does Revenue Cycle Management affect practice’s reimbursements?

In recent years, Revenue cycle management has shown substantial growth and is expected to show lucrative growth in upcoming years. In healthcare, the revenue cycle management manages all the components from obtaining patient information, to integrating workflow so that output is hassle free approval of the claims.

There is increase in patient inflow drive and costs due to the ever changing terms and condition and rules in healthcare system. Any improvement in collection can have a significant impact on practice’s profitability and longevity.


Words from Our Clients

K. Ramesh Reddy

We use iPatientCare for medical billing. They are reliable, the staff is knowledgeable, and they help address the day-to-day bill and receiving issues we all face in practice. The staff is very efficient, responsible and courteous, their attention to detail is good. Our account receivables have remained manageable and their integrated software have helped us to keep track of money owed by payers and patients when they come to see us at the office.

MD, Decaturville Family Practice


There are many ways to implement revenue management so that it can offer unique opportunities for those seeking workable, practice-specific strategies. For instance, the practice can improve speed of patient preregistration and registration, easy billing and follow-up services, ability to generate clean claims and use of EHR to drive consistent coding. Some of the other benefits for working with right type of revenue cycle management vendor are:

  • Proper medical coding and billing patterns will protect against loss of revenue. An experienced billing team will always be prepared and updated with all the ICD 10 codes and other medical coding.
  • A good revenue cycle management vendor will easily streamline documentation from EHR. A good EHR includes charting, scheduling, lab integration, billing, and e-prescriptions.
  • The practice will be streamlined and providers’ main focus will be on patient care, as the billing and coding system will be operating with full efficiency by the vendor.
  • The right billing company will provide you the customer service and educational training whenever required.
  • The medical billing company gives the paperless option so that the practice remains less cluttered.

Healthcare is unique, but it is still a business, so it becomes critical to handle the finances. Therefore, it is very vital to handle the practice’s revenue cycle management in a fruitful way and stay focused on the patient care.

Revenue cycle management assists in tracking processes from start to finish. It speeds up the patient registration process and follow ups, avoiding any lost collections. The use of EHR to drive consistent coding and ability to generate and transmit clean claims is one of the most important priority of this cycle.

How does the use of EHR software improve revenue cycle management?

Medical billing ensures that healthcare providers are reimbursed for their services, simultaneously EHR helps practices increase their collections and be more productive. The EHR has released numerous features to help providers with documentation, code look up and claim scrubbing.

The ambulatory EHR software runs an analysis on the claims that are being rejected, and let users analyze reasons for claims rejection, making necessary changes to prevent ongoing, repeating problems with the claims. It also provides variety of documentation options that include free texts, voice-to-text or structured fields.

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Electronic health records are a time savior for revenue cycle management because of its feature – easy point and click for selecting codes for particular illness and at the same time improving data accuracy.

How to improve Revenue Cycle Management for your practice?

Healthcare revenue cycle management is separated by front and back-end functions. Front-end of the revenue cycle is patient- facing. In back-end, revenue cycle management performs claim management, denial management, medical billing, and lastly patient financial responsibility collection. iPatientCare takes care of full back-end office in similar manner and guarantees more accurate reimbursement.

Secondly, using the data of the practice to track the key performance helps to know where the practice stands. It helps to know if the practice is going in right directions. Thirdly, revenue cycle optimizes patient collections by implementing point-of-service or pre-service payment options.

Lastly, automating prior authorizations and eligibility requirements reduces unnecessary costs. Manual processes to check prior authorization turns out to be costlier, whereas prior approval for the medications, medical tests, and other medical devices results in less time to treat patients and saves costs.

What are latest trends in revenue cycle management software?

Typically, data starts getting collected when patient calls a provider to schedule an appointment. That is why it is important to make sure that the revenue cycle management is running smoothly by engaging clinical staff during the pre-authorization process. This decreases the risk of rework or incorrect documentation.

The practices should constantly measure their performance so as to identify the areas for improvement. Must always know that the quality care is increasingly tied to healthy revenue through accurate documentation. Some of the other trends of revenue cycle management are:

  • Under patient responsibility, must have clear payment options, including clarification on what insurance will pay and what is owed by the patient.
  • Tailor to specific needs by automatically scheduling a follow-up visit or an annual exam.
  • Well-designed statements, effective appointment reminders, follow-up surveys and bill-pay options are valuable components required to have a successful revenue cycle management for the practice.
  • Patient experience is a top priority.

Most important component of RCM is, communicating with various health insurance companies. When a patient check in his/her insurance coverage is reported, after that the patient receives the treatment for the given condition. Contributing to the capture, management and collection of patient service, are some of the administrative and clinical functions that are included in the revenue cycle. To summarize, revenue cycle involves:

  • Charge capture
  • Claim submission
  • Registration
  • Patient collection
  • Remittance processing
  • Pre-registration

Outsourcing to the proper Revenue Cycle vendor can help practices to cut down on denied claims. It ensures that correct information is entered from the beginning so that there is no resubmission and it also gives the providers better insight into why certain claims get denied and how to rectify the issue. Outsourcing ensures proper and timely reimbursement for the practice. It potentially improves speed of registration, providing consistent coding by using EHR and avoiding lost collections. It overall increases practices’ ability to generate and transmit clean claims.

Outsourcing revenue cycle management gives providers the chance to focus more on the nuances of delivering proper patient care and take it for granted that their claims are running as expected.

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