How To Enhance RCM in Healthcare
As your medical practice grows and adds new patients, you expect your bottom line to increase accordingly. But with growth comes increased workloads for your back office. You can hire new medical coders or billing specialists, but that requires a substantial investment in recruiting, onboarding, training, and compensation.
A more cost-effective way for an organization to improve its revenue cycle management is to outsource billing and coding services to a specialist. An experienced and certified team improves medical coding quality and frees you and your in-house team to focus on patient care and core daily functions.
Let’s examine ways to improve revenue cycle management in healthcare organizations through outsourcing:
Medical Billing
A solid financial footing is built on efficient medical billing. If insurance companies routinely deny claims or patient accounts are delinquent because you don’t have a follow-up procedure in place, you’re losing out on revenue. Claims and accounts receivable management are two of the most beneficial medical billing and coding processes in healthcare.
Claims management services handle everything from processing to denial adjudication. Resolving denied claims in a timely fashion, no matter the reason, is critical. An outsourced medical billing partner uses proven strategies to appeal, reverse, or correct denied claims to keep your cash flow steady.
Another way an organization can improve its revenue cycle management is accounts receivable management. Using sophisticated software and best practices, AR specialists track delinquent accounts and effectively follow up on them. These services are vital in minimizing the time accounts are in AR and maximizing your reimbursements.
Medical Coding
If you’re wondering how to enhance RCM in healthcare, look no further than medical coding. Submitting the proper codes while following all coding guidelines is complicated, time-consuming, and complex. Trusting your medical coding to a team of experienced AAPC-certified medical coders ensures accuracy and efficiency.
Their working knowledge of procedural codes and modifiers—together with meticulous attention to detail—ensures you’re appropriately compensated for your services, and the chance of denial is minimized. But medical billing requires more than correct codes.
Coding compliance is essential. Healthcare organizations face growing regulations every year. Certified medical coders who verify the coding of data, diagnosis, and procedure are all within regulatory compliance and the law.
The Benefits of Medical Billing and Coding Process Improvements
When an organization improves its revenue cycle management, it can expect to experience several benefits, including:
- Maximized reimbursement: Medical billing and coding process improvements maximize revenue and cash flow. Insurance companies and individuals are accurately and efficiently billed for your care. Claims management makes sure any issues or hold ups are quickly resolved and your turnaround times are minimized.
- Lower costs: Not only can enhancing RCM in healthcare increase revenue, it also lowers operational costs. Outsourced specialists typically charge a small percentage of total payments collected. Compared to the price of adding enough staff to handle your workload sufficiently, a billing and coding partner adds tremendous value.
- Assured compliance and security: Incompliant RCM puts you at risk of fines, penalties, security breaches, legal battles, and loss of trust with your patients. Upholding coding compliance is an absolute necessity as regulations grow more strict and far-reaching yearly.
- Reliability: The quality and accuracy of expert billing and coding provide the comfort of knowing your claims are meticulously compiled and processed. Billing and coding specialists are available anytime. You don’t have to worry about falling victim to staff shortages, vacation requests during busy times, or inexperience.
- Improved patient care: When you find ways to improve revenue cycle management in healthcare, you’re free to focus on your patients and their experience. The demands of running a medical practice, meeting coding compliance, and tracking payments can distract practice managers and providers from what matters most—their patients. When you remove those obstacles, you’re free to focus on medical care.
Do you want to learn more about how BSI Medical Billing can handle billing and coding needs for your practice?
Use Auditing as a Way To Improve Revenue Cycle Management in Healthcare
One of the best ways to enhance RCM in healthcare practices is by undergoing comprehensive audits. Taking a deep dive into your strategies, techniques, and processes gives a holistic view of your RCM. Using audit findings to uncover inefficiencies or problematic practices is fundamental to developing medical billing and coding process improvements.
- Whether you choose to run an internal audit or seek third-party services, your audit should aim to:
- Reveal documentation errors
- Uncover inefficiencies in reimbursement from payers
- Determine if medical coding, including modifiers, is correctly applied
- Find problematic billing practices
- Identify EMR and software discrepancies
- Eliminate any risks to compliance
- Address claims and AR processing practices
