Blog Article

Quality Revenue Cycle Management Requires More Than a Billing Company

According to the recent article The Ongoing Evolution of Healthcare Revenue Cycle Solutions,  revenue cycle solutions are not just about billing.  Author Aubrey Westgate shares, ”As healthcare changes, the way practices and health systems think about revenue cycle solutions will begin changing as well.” Awareness is the first step towards an improved financial future. The second step is selecting the right service organization to meet your practice needs and maximize your revenues.

Today, medical practices face an unprecedented economic challenge with increased pressure to collect more while cutting operational costs and providing top-quality care. The revenue cycle is more complex and difficult to manage than ever due to the tumultuous healthcare environment.  Is it possible to survive these complexities while keeping a practice afloat?  We believe the key to success is selecting the right partner to meet your practice’s needs.

When managed professionally, Revenue Cycle Management can boost profitability, improve productivity and contribute to an improved patient experience.  Professionally staffed RCMs help correct the balance between payers and providers by supporting solutions to increase automation, streamline workflow and improve financial performance.

To help you identify the right professional RCM service, we’ve answered some common questions by including the key factors to consider.

Q: How can a discovery meeting benefit my practice?

A: Discovery Meeting    A discovery meeting is designed for two-way interactions between the practice and the RCM professionals.  It is an opportunity to share and learn about the current practice challenges and to identify solution strategies.  A professional services company can offer a wide range of support that leverages industry expertise, processes and technology solutions.

Q: We seem to be managing just fine, what more can an analysis reveal?

A: Workflow Analysis    Benchmarking against industry standards is the first step to taking a closer look at financial performance.  How does your practice compare to similar practices by discipline and geography?  Addressing or correcting poorly functioning processes can boost profitability instantly.  With the right tools, practices can increase their collections, reduce denials & underpayments, and respond on a timely basis to lost or ignored claims.

Q: Will I have to switch platforms?  My staff is happy with our current application.

A: Networking Support   The right partner in RCM provides options to integrate with an existing PM or EHR platforms or offer upgrades to  hosted applications.  Today, cloud based services offer more cost effective solutions than ever before.  The technology experts will utilize state of the art tools to improve your processes with solutions scaled to meet the practice’s needs and reduce errors.

Q: We are happy processing paper claims.  Why do away with current processes?

A: Automation   The best way to stay in front of the constantly changing payor rules is through a powerful PM system that incorporates a clinical claim scrubber.  Electronic billing is more efficient and results in faster collections and fewer claim denials.  Claim scrubbing ensures that claims go out correctly the first time.  Tools to automate plus the intelligence to reveal problems contribute to faster payments.  Automated eligibility is built into the system resulting in more accurate patient enrollment information. The right application can respond in defined ways to all kinds of events, such as patient scheduling, expired due dates and upcoming deadlines.

Q: I haven’t reviewed a report in months?

A: Reporting   Consistent and regular reporting is essential to every practice’s financial health.  Comprehensive reporting is critical to controlling costs by keeping tabs on lagging collection times, excessive write offs and improper coordination.  Reporting also plays a key role in moving forward to new payment models that include PFP and PQRS. Key Performance Indicator Dashboards provide comprehensive and updated views in real time reporting.

There are significant differences between a professional services company and a billing company that every practice should understand.  In consideration of the ongoing evolution of healthcare revenue cycle solutions, it is more important today than ever before to align with the right partner.

Next:  How would you value a benchmarking analysis?