Best Practices for Revenue Cycle Management

The outcome or profits of your practice hold a significant role in determining its longevity and progress. A revenue cycle management service manages and maintains these profits without making them fall to the lowest points. Figuring out where to get the money from and what amounts are collected is the domain of an RCM service.

The revenue cycle management process involves several steps and practicing each step with care, and precision is crucial. As soon as the patient opts to schedule an appointment, the revenue cycle begins, and you need to do the analytics here. You need to consider incorporating a few practices that will make the RCM process much more efficient, reliable, and beneficial.

Keep reading this blog to learn about the best practices of revenue cycle management and the benefits they offer to your practice.

11 Best Practices For Improve Revenue Cycle Management

Multiple factors are associated with improving your practice’s revenue and profits, and this is only possible when you have a revenue cycle management service. Irrespective of the size of your practice, the complexities of RCM will always exist, and you will require expert help. The expert services follow a few tips and opt for some practices that ensure maximum reimbursements with increased practice revenues.  

Below are a few revenue cycle management practices that you must follow to guarantee the maximization of profits.

1. Appointment scheduling

The first and foremost step in increasing and improving your practice’s revenue is getting maximum appointments. The higher the number of appointments, the higher the number of people paying you for your practice. The revenue cycle management service must schedule these appointments.

For this, revenue cycle management needs to practice early registration processes. With registrations, appointment follow-ups are followed to ensure the patient never misses an appointment. This is why having an EHR system is mandatory.

2.   Patient and insurance verification

Verifying the registered patient before providing any services is one critical step for improved revenues. You must identify the patient's payment preferences for the services and treatments they are getting. Make it clear to the patient about the payments they will make and the payments their mentioned insurance company will make.

These verifications are crucial to conduct before the patient meets with the practitioner so that the patient is also aware of the payment preferences. However, the insurance payer should be contacted earlier to avoid claim denials affecting your revenue.

3.   Accurate Coding

This is where charge capturing begins, and you define the actual amounts to be reimbursed. It is crucial for improved and managed revenues that healthcare providers code the services and treatments accurately. Leveraging the services of an expert medical coding company will guarantee the management of the practice’s revenue.

These codes should be accurate, compliant, and updated to avoid denials and billing errors. Frequent coding errors and issues affect reimbursement rates, which in turn affects your revenue cycle.

4.   Use technology

Nothing can beat technology when it comes to accuracy and efficiency. To bring efficiency and accuracy to your revenue cycle management, you need to consider top-tier technology and software. With this use of technology, the elevation of revenues is negligible and all this is because of the process automation. From quick patient registrations and verifications to minimal billing inaccuracies are all because of the technology.

With the use of the latest tools and technology comes these benefits:

·         Accurate patient data

·         Process automation

·         Billing accuracy

·         Real-time data

·         Streamlined communications

·         Code updates

5.   Timely claim processing

The next very big thing in improving your practice’s revenue is processing the claims on time. The insurance payer will not take the initiative to pay on their own and may choose not to pay if not asked. You must process the claims as early as possible to keep your revenues up and managed.

Moreover, the management of the claims is also mandatory. This way you get to know which of the claims are processed and which ones were rejected or denied. For denials, billing precision with proper documentation is required.

6.   Manage denials

Getting denials frequently will make you reach the bottom line of your revenues, and you must not let that happen. Firstly, avoid denials and manage them. Denial management demands expertise and skills, and these skills are the only way out of struggling revenue cycles. Denial management lets you get to the root cause of the denials and correct them to ensure reimbursements.

The best way to manage these denials is as follows:

·         Identify the root cause

·         Classification of denials

·         Minimize billing mistakes

·         Take no more time to process claims

7.   Follow-up on denials

If minimizing the accounts receivable and increasing the cash flow are the objectives, then following up on the claim denials is one of the pivotal things. After you identify the reasons for the denials, it is now time to resubmit the claims, addressing all the factors that were missing in the previous one.

Failure to follow up on denials leads to a poor revenue cycle and the revenues for your practice will decline drastically. You need to make sure that you are not taking years to follow up on denials because you may never get back the amounts you deserve.  

8.   Monitor Accounts Receivables

One of the reasons why your revenues are falling each passing day is because of piled-up accounts receivables. It is the responsibility of the revenue cycle management service to keep track of these accounts and keep them minimal. With increasing A/R the profits will be lower.

Monitor all the receivable accounts and track the period. If the receivables are pending for a very long period, then they need your immediate attention, because they should not exceed a given time.

9.   Consider staff training

Your revenues are affected and are stooping very low because of the medical billing inefficiencies and inaccuracies you are offering. It is very crucial to avoid and dodge these errors and inaccuracies to maximize your profits. One of the best practices to maximize revenue is by training the staff responsible for revenue cycle management.

The training of the staff brings these tangible benefits:

·         Error omission

·         Timely processing

·         Code knowledge

·         Code Compliance

·         Reducing risks

·         No denials

10. Consider KPIs

KPIs or Key performance indicators play a significant part in maximizing and managing your revenues. With these KPIs, you get to know about the performance of your revenues and get a better idea of where they struggle. These performance indications provide you with the necessary information and details that enable you to take steps to improve the revenue cycle.

Some of the significant KPIs you should know are as follows:

·         Total Reimbursements

·         Collection rate

·         Denial rate

·         First-pass payment rate

·         Patient Satisfaction

·         Days in A/R

11. Outsourcing a service

Last but not least, one of the crucial steps you need to keep in mind is to outsource the best medical billing service. With this medical billing service comes the benefit of improved revenues and revenue cycle management services. Opting to manage your revenues on your own won’t work.

Outsourcing a reliable service makes you carefree about your revenue management because the experts are on duty. If professional ones are hired, these outsourced services will improve and manage your revenues.

Top 5 benefits of outsourcing Revenue cycle management services

The intricacies of managing your practice’s revenue on your own will hit you hard, and you will fail to keep your practice alive any longer. This is why you should always opt for outsourcing a revenue cycle management service that practices the previously mentioned tips to bring maximum revenues.

Below are a few negligible benefits outsourcing RCM services brings to your practice.

1.   Increased practice collection

One of the most prominent and tangible outcomes of outsourcing the best RCM service is an increase in your practice’s collection rates or reimbursement rates. Deteriorating collection rates are the reason your revenue is struggling, and this can only be improved with a professional RCM service. These collection rates are higher because the outsourced revenue cycle management service has made efforts to submit accurate claims on time.

2.   Patient Satisfaction

Better guidance to the patients about the payment upfront brings peace and satisfaction. Moreover, easy and quick patient registrations are among the factors contributing to improved patient satisfaction. The higher the patient satisfaction, the higher the appointment rates, which is a practice that enhances the practice’s revenue. Moreover, the practitioner will provide better patient care because all the attention will be on the patient instead of the revenue management.

3.   No administrative burden

Outsourcing the experts will be the best decision you will ever make for your practice. These outsourced professionals are aware of the RCM flowcharts that could improve your revenues. When such professionals are on duty, you no longer have to bear the burden of RCM. Minimizing the administrative burdens off your shoulders will help you improve the quality of your services.

4.   Lower denial rates

The outsourced professionals know the tips and tricks for minimizing the denial rates and maximizing the acceptance rates. This is the reason why your revenues tend to improve more with experts. The outsourced revenue cycle management service must know the right and accurate billing codes and techniques to avoid denials. With their knowledge of precise coding, they put an end to increasing denial rates by replacing them with higher acceptance rates.

5.   Timely solutions

It is evidently possible that you and your staff are busy performing the core duties, and you may not have the time to manage the revenues. But when it comes to outsourced RCM services, the provision of timely solutions is always there. You no longer have to worry about delays in claim processing and getting the reimbursements late. The professionals know when and where to process the claims to keep your practice’s revenue managed and improving.

Get your revenues managed and improved!

Are you struggling to manage your practice’s revenue? If yes, then you have come to the right place because we offer professional and expert medical billing services. Our medical billing service also offers revenue cycle management services that will help keep your revenues higher and improve by opting for the best RCM practices.