Cloud-based solution
A cloud-based solution for medical billing services is one of the best tools to consider when implementing healthcare revenue cycle management software for your medical practice. To make the RCM worthwhile, your provider should provide you with unrestricted, on-demand cloud access to all of your data 24 hours a day, seven days a week, and 365 days a year.
One of the most important advantages of cloud computing is that healthcare organizations can access archived data even if their local computer systems are down. This provides relief to healthcare organizations concerned about losing patient information if computer hackers infect the network with malware, such as when ransomware attackers demand payment.
Cloud computing is also advantageous because it allows you to quickly recover from a disaster thanks to safe and secure online backups. Because RCM in the cloud allows you to expand your business by adding a satellite office, employees in the new location will have easy access to your servers.
Training on RCM
Check with your Revenue Cycle Management software provider to see if they provide comprehensive denial management and RCM training on how to use the system for any functions you might need.
Important note: Before ordering Revenue Cycle Management software and training materials, you should first try out an RCM software demo to see if all of the features are available (or training sessions). If the product being offered is not the right fit for your healthcare organization, this saves you and the supplier a lot of time.
Claim Submission
Prudent office managers and healthcare providers understand that working with an RCM that can ensure claims are submitted at their highest possible value before being submitted is more efficient. This is especially true when considering possible reimbursement reductions.
It’s easier to use RCM software as a practice management system to keep track of claim values; otherwise, proper payments could fall through the cracks, causing you to wait longer for reimbursement. This method saves time for employees, which contributes to a positive bottom line.
Eligibility & Benefits
How much time do you think your employees spend on mundane tasks like confirming patient eligibility? This will be especially difficult as the year progresses and you assist patients who have transitioned to Medicare Part C, a Medicare Advantage plan, or a Medicaid-managed care plan.
The RCM software’s in-advance mechanisms are ideal for checking for prior authorizations. Many medical care providers use their RCMs as practice management systems on a regular basis to speed up the process of estimating patient responsibility amounts and displaying co-payments.
Real-time Tracking
You don’t want to wait an unreasonable amount of time just to correct a mistake made by a busy employee. The ability to track submitted claims in real-time and check on their status will be one of the most useful RCM features available to you.
Notify Denials
Of course, setting up your RCM system with proactive denial alerts is the best way to avoid denials in the first place. When an RCM cannot detect incorrect data, it slows worker productivity and can obstruct the flow of payment processing in your company.
KPIs and their Insights
When you set up your RCM to generate reports, including documentation for the Protecting Access to Medicare Act, or PAMA, as well as financial and managerial reports, preparing for weekly meetings where the staff gets together to go over reports will go much more smoothly and quickly. Key performance indicators, or KPIs, can also be developed and tracked using healthcare revenue cycle management tools.
In the healthcare industry, revenue cycle management (RCM) is the process of handling claims, processing payments, and generating revenue. It starts the moment a patient schedules an appointment and continues until his account balance is zero. It entails a number of steps, such as determining patient insurance eligibility and coding claims.
Benefits of RCM in HealthCare
- By registering, appointing, scheduling, and processing payments, a well-designed RCM system simplifies the billing and collection cycles.
- Communication with the EHR and accounting systems is made easier with RCM.
- It brings the business and clinical sides of healthcare together.
- Revenue cycle management systems assist healthcare providers in preserving and managing patient billing records.
- It allows the RCM system to perform tasks on its own.
- RCM is in charge of all administrative tasks, such as reminding patients of upcoming appointments, reminding payers and patients of outstanding balances, and questioning insurers when claims are denied.
- It saves money for providers by reducing the number of claims that are denied and allowing patients to pay their bills online.
- It allows healthcare workers to enter all of the information needed for claims processing, avoiding the need for claim revision or resubmission.
- RCM, or Revenue Cycle Management, is a complicated process that you must understand in order to run your practice successfully and efficiently.
- By establishing a policy to always verify eligibility and benefits after providing services, you can avoid billing issues.
