Get Your Pieces Together for a Healthy Revenue Cycle

One of the best ways to verify if your medical billing department is efficient enough is to look at the accounts receivable reports and see the percentage of claims that due over 120 days. Looking at this figure and comparing it with the industry standards will give a pretty good idea of how your revenue cycle management is and if you need to take any corrective measures to improve the performance. You would need to take measures if the percentage is higher than that of the industry which means you are not able to collect the money due to you efficiently. Let us see here, how the issue of due claims over 120 days can be sorted out.

Get the correct start: The process of patient services and the payment of those services start at the front desk. So, it is on the part of the RCM services professionals to ensure that they collect accurate and complete information regarding the patient in the initial stages itself. The details regarding a patient’s insurance and its coverage should be double checked.

Make a financial agreement: It is a good thing to enter into a proper financial agreement with the patient for a healthy revenue cycle management. It makes sense to include collection fees, charges for after-hours advice, and any other kind of collection costs in the financial agreement to ensure you are fully equipped to collect any dues from patients without any hassles.

Understand the claim submission: RCM services professionals should be fully aware of the claim submission procedures and about the clearing houses that process your electronic claims. Not all clearinghouses are the same, and some provide speedy follow-up procedures within their systems. Some clearinghouses even communicate with the insurance companies in real time to cross-check if something is incorrect and send it to you for rectifying the issue.

Get timely follow-up done: RCM services providers should ensure that there is dedicated staff who work on the follow-up of accounts that have receivables. If this task is handed over to the front desk staff, they may not be able to focus on the follow-up of accounts receivables as they have many other pressing duties as well. If not properly followed-up, a facility may lose thousands of dollars in accounts receivables.
Make arrangements for patient collections: The staff should be made accountable to collect the dues from them on time and if they are not able to collect, then arrangements should be made to hand over the task to a collection agency or take a legal action.

There are a lot of things involved in getting claims paid accurately and in time. The entire process of collections that starts at the front desk should be efficiently and effectively handled by experts in the field to avoid losses due to failure in collections. Hiring a proficient RCM services provider is the key to a healthy revenue cycle.