As more patients start showing up, it becomes exceedingly demanding to manage various aspects related to the Revenue cycle management of your practice, especially considering the limited staff. Just when the practice starts seeing growth, the key responsibilities arising from patient care make it difficult to devote round-the-clock attention, time and concentration to insurance collection, which in turn affects the flow of cash and patient experience. The disturbance in revenue management could eventually end up disrupting the overall functioning of the firm. As a result, it becomes fundamental to outsource RCM or Revenue Cycle Management to expert professionals-Thus making the process easier, cost effective and time-saving.
Revenue Cycle Management consists of several tasks which need to be carried out in a timely and efficient manner, the failure of which can lead to leakage or block in cash flow, affecting the overall payment cycle which subsequently impacts the patient experience. In addition to excellent patient care, the true result is dependent on timely payments from insurance carriers and patients, as well as accurate claim submissions. It is almost impossible for any provider to manage both excellent patient care as well as to stay up to date with the changing insurance regulations and acting according to them. Outsourcing RCM can assist in eligibility checking, timely submission of claims, payment postings and appealing to denied claims.
Reasons for outsourcing RCM services
- Checking and verifying a patient’s insurance coverage can be hectic with the limited staff.
- Failure in collecting payments and balances can hamper the cash flow cycle.
- There are high chances of human error, which can lead to claim denial.
- Staying in touch with the various changes in insurance processing can be a challenging task.
- Delay in any of the insurance processing stages can lead to claim denial.
- Insurance denials need to be followed up in a timely manner, failure of which can cause loss in revenue.
- Hiring in house staff can be costly and stressful
When outsourcing RCM services, a lot of things need to be considered. Recognize the range of services offered by the company. Consider the terms of the contract, the insurance companies to which they submit their claims. Make sure that they offer experienced professionals. Thus, with a professional company backing you, you can devote your time and effort to patient care.
Services provided by outsourcing RCM
- Patient Enrollment and Schedule Management
Patient Enrollment has a huge impact in your revenue cycle as inaccurate entry of patient details and other information could result in denial of insurance claims and other complications. Therefore it is important to enter accurate information. With outsource RCM services, patient schedules and other information are accurately maintained and updated.
- Eligibility checks
RCM services make sure that the patient is eligible for insurance services as it is one of the main criterias for insurance claim.They see to it that the inaccuracies in eligibility is eliminated ahead of claim submission.
- Claim submissions
RCM services makes sure that clean electronic claims are submitted. They remain up-to-date with the changing insurance processes and make changes accordingly before submitting your claims. Submitting proper claims can lead to faster reimbursement, ultimately improving your overall revenue.
- Error-free coding
RCM services help in ensuring that the insurance claims are properly coded. The claims are properly analyzed and the various errors in coding are found and resolved immediately.
- Payment Posting
RCM services process all patient’s payments with extreme accuracy and post the payments into the patient’s account. It provides an opportunity to analyze and maximize the overall revenue.
- Denial Management
RCM services help in analyzing and resolving the various reasons leading to claim denial. Once the issues are resolved, the request is resubmitted and appeals are filed. Denied claims can lead to a huge loss in revenue. Therefore it is very important that the denied claims are acknowledged as soon as possible.
Benefits of Outsourcing RCM Services
- Increased Cash Flow
With no outsourcing, the RCM needs to be handled by the staff and the absence of any of the staff could result in unattended insurance claims and denials, which eventually reduces the overall revenue of the practice.But with outsourcing, these issues could be avoided, thus increasing the cash flow. With this the practices and providers will be able to receive the revenue that they deserve by solving the denied claims, thereby avoiding uncollected insurance revenue.
- Increased focus on patient care
Patient care is essentially one of the most important aspects of any practice. But with the growing number of patients, it becomes extremely difficult to prioritize both patient care as well as revenue cycle management. It at times can become difficult to provide uninterrupted attention to patient care and engagement, which can even break the interest and trust of the patient in your practice. But with outsourcing RCM services, the practices can provide undivided attention to their patient care.
- Time saving
Since your RCM service provider handles the entire revenue cycle, it gives you enough time to focus on other critical aspects of work. With a less number of staff and more time, it will be easier to allocate more time to patient care.
- Reduced Denial of Claims
Your RCM service provider will ensure a complete error-free billing process. Since the complete revenue cycle is handled by expert professionals, there are fewer possibilities of any error happening. This in turn reduces the possibility of claim denials and increases the claim acceptance rate.
- Reduced Number of staff
Your RCM provider ensures the handling of the entire revenue cycle, thereby eliminating the need for an in-house staff. The time, effort and cost required for managing the staff could thus be avoided.
- Staying up-to-date with changing Insurance processes
Your RCM service provider will stay up-to-date with the varying insurance processes and will accordingly make changes to their work so that you don’t have to worry or stress about any of it.
CareRevenue could be your ideal RCM service provider as we deliver services that help you maximize your revenue. We extend our team of expert professionals who would manage the overall revenue cycle. We help you deliver uninterrupted time and focus on your patients, presenting them with excellent care and treatment without any other worries or stress.