Revenue Cycle Management (RCM) Strategies to Improve Practice Revenue

Introduction

The Revenue Cycle Management (RCM) strategies implemented by your medical practice will determine, influence, and transform its revenue. It includes how claims are handled, how patients pay, and how internal billing functions. If these techniques are not used, it may be difficult for clinicians to maintain a high proportion of clean claims and accurate billing. Using RCM strategies help maintain the regular income of your medical business and generate a steady income stream. Therefore, providers should consider the possibilities and techniques to generate additional revenue for their practices by employing RCM strategies.

Continue reading this post to learn about revenue cycle management best practices. This article reveals the revenue cycle management strategies. These strategies help in improving revenue cycle management.

Revenue Cycle Management Strategies

The below revenue cycle management strategies are important for improving the revenue.

1. Difficult Patients

Since high-deductible health plans are gaining popularity, customers bear a greater portion of their health care expenses. It can be difficult for physicians, especially small-practice owners with limited financial resources, to receive payment from patients for their services. If you do not receive payment from patients at the time of service, the likelihood of getting the money back decreases weekly. The effective way to get payment from such difficult patients is to ensure they are eligible for all their benefits and programs. Before each visit, you must have a current report on each patient’s insurance coverage. You can use the eligibility and benefits report to determine whether or not your insurance will cover the scheduled treatments, how much your copayment will be, and whether or not you have any remaining deductibles. Before a patient arrives for a consultation, you can discuss their out-of-pocket expenses and payment options. It will need less money and time, and you will receive more patient payments in less time.

2. Clean Claims

A clean claim contains no incorrect or missing patient or insurance information. Your success rate for clean claims should ideally exceed 95%. When an insurance company receives as many error-free claims as possible, it increases the likelihood that the claim will be processed on the first attempt, which expedites payment. Your claim could be denied for various reasons, including incorrect insurance information, incorrect DOS, incorrect patient information, incorrect billing information, non-payable diagnosis codes, incorrect NPI, etc. It would be best if you streamlined the front-desk duties to increase the number of clean claims. It will require obtaining and validating patient and insurance information before the planned appointment. You can compare patient data and insurance information if you create an account on each payer’s provider portal. It is among the important revenue cycle management strategies that will ensure that your claim is as error-free as possible. You can access this data with a single click when using billing or clearinghouse software from certain businesses. By streamlining all billing activities before submitting a claim, achieving a clean claim rate of greater than 95% is simple.

3. Billing Software

Tailored billing software helps in improving revenue cycle management. It is crucial to choose tailored software. The billing software that does not offer tailored solutions cannot meet the prerequisites of specialty-wise medical billing. Contrarily, specialty-specific software helps providers access tailored billing tools. These include claim filing and coding tools that help optimize the practice’s revenue. An important beneficial feature of such software is that it notifies diagnosis codes that are non-billable, leading to claim denial. With timely notification, the software reduces the chance of denied claims; thus, it helps in improving RCM.

4. Patient Scheduling

Improving patient scheduling is among the most important revenue cycle management strategies. It plays a significant part in improving the revenue of the medical practice. When patients miss their appointments, the practice’s finances are severely impacted. If providers can reduce the number of patients who miss their appointments, they will be able to bill for more completed services, provide more follow-up treatment, and spend less time waiting for no-shows. Using high-quality integrated practice management software and a patient portal can improve scheduling. Providers can improve the number of appointments they schedule and significantly impact the profitability of their medical practices by utilizing the appropriate software.

5. Multiple Payment Options

You must accept various patient payment methods to be paid on time. Patients need the ability to pay their medical costs online or over the phone. If this option is unavailable, patients are more likely to forget to pay their medical bills or not pay them at all, negatively impacting your practice’s revenue. Another strategy is to keep their credit card details for recurring payments like copayments or deductibles. The most effective method for collecting payment from a patient is to give them a cost estimate before the visit and request payment at the time.

Revenue Cycle Management Best Practices

Following are the revenue cycle management best practices that help in improving the revenue of your practice:

Patient relationship management: Better patient relationship management is crucial for healthcare practices to maximize RCM. If the staff goes above and beyond to ensure patient satisfaction and cultivates positive relationships with them, patients are more likely to remain loyal to the practice. It is among the revenue cycle management strategies that help in increasing revenue. Many patients find the process of paying medical bills to be difficult. The more a patient discusses this issue with the staff, the more probable it is that the patient will pay the provider.

Eligibility and Prior Authorization: You can collect more money from patients if you inquire beforehand about their copayments and deductibles and provide many payment options. The first step to effective RCM is ensuring that the patient has insurance at the time of enrollment. Prior authorization and coverage requirements are becoming more stringently enforced by insurance companies. Prior authorizations and eligibility checks can be performed automatically to help optimize clinical procedures, accelerate the revenue cycle, and reduce the time front office personnel spend on this task.

Timely Filing of Claims: Numerous healthcare organizations do not always submit their claims on time, missing the filing deadlines. In the event of missed deadlines, claims cannot be paid, and therapeutic services must be wiped off. It is essential to implement procedures to guarantee that deadlines are reached.

See Also: What Is Coding and Revenue Cycle Management?

Conclusion

By employing Revenue cycle management strategies, a practice can generate more revenue, but it requires a team effort, not just the efforts of a single physician. Your receptionists, billers, and medical coders should all be able to assist you in the same manner. You can also hire Precision Hub (PH) expert services to manage your billing requirement.

At Precision Hub, we will handle all your responsibilities so that you can concentrate on caring for your patients. These include insurance coverage reports, prior authorizations, payment posting, denial management, and accounts receivable management.

Contact us and learn how we may assist you with RCM procedures and increase the profitability of your practice.