Understanding Revenue Cycle Management and Its Impact on the Health Care Industry

Plus, Ways to Improve Your RCM

Revenue cycle management plays a pivotal role in the strength and survivability of an organization. Management begins when a patient makes an appointment and continues until final payments register. It sounds straightforward, but the health care industry constantly presents challenges for this process, including the transition from fee-for-service to value-based care.

To effectively navigate this environment, medical providers need a deep understanding of how RCM works, as well as knowledge about options for improving RCM processes already in place. A healthy RCM system can assist in meeting those challenges, ultimately improving collections, increasing revenue, and strengthening financial viability.

The following information details the importance of RCM, the advantages it can deliver, the challenges addressed, and tips for evaluating the strengths of processes implemented.

An ApolloMD revenue cycle management professional will be happy to answer any questions you may have. Contact us online or call (770) 874-6888 to learn more.

Success Begins Here

Prioritizing revenue and efficiency while reducing mistakes and expenses are top priorities for any size group. Best-in-class RCM can help accomplish each of these goals.

BENEFITS

Adopting a strategic approach to RCM can benefit your organization on several fronts, including:

Identifying Problems and Correcting Issues

A strong RCM process provides key analytic insights into what is happening throughout your organization. RCM can help you identify trends to maximize efficiency while also providing the data needed to pinpoint any weaknesses and address them much faster.

Reducing Admin Burnout

Administrative burnout is real and can negatively impact a health care organization. Governmental requirements, health care regulations, and insurance models continually evolve, creating new demands on staff. An effective RCM system can reduce administrative burdens, helping to retain critically important personnel as a result.

Increasing Patient Satisfaction and Compliance

RCM systems typically offer patient portals, facilitating patient adherence to health insurance guidelines as well as clarifying options to avoid high out-of-pocket costs. These portals can also reduce errors in claims.

However, when patients enter information incorrectly, the errors may cause delay in care. Strong RCM processes can verify this information, and discover any discrepancies before they cause problems for the organization or the patient. RCM can also eliminate medical identity theft, creating alerts to signal potential problems and alleviating that responsibility for staff.

Increasing Revenue

RCM can also streamline the revenue cycle, ensuring that payments are collected efficiently without compromising your ability to provide the highest quality of care. Reducing errors and redundancy in this manner can increase revenue while simultaneously reducing debt.

CHALLENGES

Implementing RCM can eliminate many of the complications that can bog down even the most efficient health care operation. Below is a list of common challenges faced by hospitals and private practices alike.

Collecting Payments

Integrated RCM billing solutions such as patient portals make it easier than ever for patients to view and pay their bills. The more efficient your collections system, the smoother your operation will run.

Coding Errors

Coding errors will slow the revenue cycle, or even stop it in its tracks. For example, inaccurate documentation of medical codes can lead to denial of insurance payment. This can happen at any time and is the biggest challenge to receiving timely payment. Effective RCM processes can reduce compliance risks associated with coding and billing errors, streamline billing, automate inefficient processes, and ensure a consistent payment schedule – safeguarding your revenue and curtailing problems.

Moving Forward

Implementing RCM isn’t an overnight process but working with a team of experts can help you integrate new platforms seamlessly, boosting your organization’s operational and financial strength. Revenue cycle management in health care is more important than ever and continues to evolve as insurance programs and governmental regulations continuously change.

New technologies are drastically reducing coding errors and making it easier for providers to offer transparent pricing, contactless billing, and many of the other services that patients request.

When considering RCM processes, remember that patient relations extend much farther than the team providing clinical care. Offering convenient, efficient patient experiences helps to also increase patient loyalty, quality of care – and your bottom line.

 
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