RCM Tips To Improve Practice Collections

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RCM Tips To Improve Practice
Collections
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RCM Tips To Improve Practice Collections
Revenue Cycle Management (RCM) includes all
activities directed toward receiving accurate
patient and insurance reimbursements for
delivered services. As most practices struggle
with reduced practice collections and increasing
expenses, we shared RCM tips that will help you
to improve your practice collections. Reducing
Claim Denials Practices are struggling with ever
increasing percentage of denied claims. Denied
claims are one of the most predictable problems
affecting the healthcare organizations cash
flow. Various sources estimate that the average
denial rate for healthcare industry ranges from
10 percent to 25 percent of all claims submitted.
However, as per the report of the Medical Group
Management Association (MGMA) the best healthcare
organization should have a denial rate of only 4
percent. You must form team of billing experts
for denial management and resolution. Just
submitting claim is not sufficient, you have to
track each and every claim, read every line item
of EOB/ERA and understand the denial code. You
must follow up on all denied claims and
investigate the missing values and determine what
needs to be submitted. Review every denied claim,
talk to insurance rep and ask for resolution.
Based of conversation with insurance rep and
inputs from billing experts, correct the claim,
provide additional information required, recheck
documentation and resubmit the claim without
further delay. Dont resubmit the claims without
proper analysis, otherwise resubmitted claims
will again get denied increasing days of your
payment cycle.
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RCM Tips To Improve Practice Collections
Reducing Write-offs Some write-offs seem
necessary, and others do not. Your billing team
should have sufficient knowledge on how to review
each account. Mostly the practices do not
emphasize lower amount of payments, but some
patients make payments in installments. If those
small payments are not managed properly, then it
eventually affects the balance sheet of your
organization. Therefore, you must remember that a
brief review of each overdue of patient account
can lead to the reimbursement of your
organization. You must identify and create a
strategy to reduce unnecessary write-offs. To
define a successful strategy, you must review the
past data and accordingly determine a benchmark
of the average write-off rate. This will help you
to set a limit for the annual write-offs that you
can control. You must determine, which write-offs
would require managerial approval. This will help
you to accelerate smaller or less contentious
accounts. Planned monitoring and tracking of
write-offs help you identify issues within your
reimbursement policies and procedures. Tracking
helps you identify the problem associated with
the higher spikes. Reducing Bad Debt Rising bad
debt is becoming the most common medical AR
problem, whereas patient responsibility
contributes to more than one-quarter of the
healthcare industrys revenue. Earlier patients
responsibility was only at the time of service,
but now it is no longer enough to discuss patient
responsibility only at the time of service. In
order to improve patient collections, it is
critical to collect payment during the entire
revenue cycle.
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RCM Tips To Improve Practice Collections
To keep away from the bad debt, your healthcare
organization must gather all the necessary
billing, insurance information, and calculate the
expected out-of-pocket costs before providing the
service to the patient. So, by verifying that
coverage, the patient would understand the
scenario and agrees to their responsibility.
Providing this kind of comprehensive billing
experience will dramatically improve the
likelihood of payment, and helps maintain a good
relationship with your patient and ensures that
they have positive billing experience. Collect
More Healthcare professionals pledge to help
patients, not to collect money from them. You
might be good at providing better patient
experience but may not be good at collecting
money from patients. But getting paid for
services provided is also crucial for maintaining
a successful practice, and continuing to provide
care. Therefore, to make account receivable a
priority, your healthcare organization must
foster a good culture of collection. Your front
desk staff must be well versed with all billing
terminologies. They must be well equipped with
information containing patients insurance
coverage report. They must be able to answer all
billing related questions asked by patients.
Insurance coverage report will help you to find
out exact patient responsibility, so your front
desk staff can collect co-payments or deductible
amounts at time of visit only. To promote a
quality culture of collection, you need to build
the right team and provide them with the right
training and tools to manage the successful
collection.
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RCM Tips To Improve Practice Collections
The revenue cycle management constitutes complex
set of tasks requiring unique medical speciality
wise billing expertise. If your organization is
surrounded by the problems that are associated
with reduced practice collections and increasing
expenses then you must reconsider the option of
outsourcing your medical billing services.
Medisys Data Solutions is such an outsourced
medical billing company providing RCM services as
per medical speciality. Once you have given us
responsibility of medical billing, you can forget
about all technicality of billing and can just
focus on patient care. To know more about our
medical billing and coding services, contact us
at info_at_medisysdata.com/ 302-261-9187
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