08 Mar Medical Billing Software with RCM
Over the last couple of years, the medical billing industry has introduced Revenue Cycle Management (RCM). This system is designed for financial management and to handle billing for medical professionals. This facilitates the job of medical billers and coders who spend years learning how to accurately devise invoices for insurance companies and individual patients.
Revenue cycle management means taking steps to ensure that you get reimbursed for services provided, and that the payment occurs in a timely fashion. The revenue cycle begins when the patient calls the office for an appointment and the secretary gets his or her name, number, and insurance information. The cycle ends when the patient balance is zero.
Many medical practice report that they cannot afford to use staff for phone calls to collect insurance information. Because of this, the front desk does not verify that the patient has insurance coverage before the office visit. When the insurance coverage is not verified before the patient encounter, the check in process delays the visit. Therefore, data gathering should be done before the patient presents to the office.
Pre-visit eligibility verification is done to prevent loss of reimbursement. If the office staff finds that the patient is not covered before the scheduled appointment, then the patient has time to contact his or her insurance company to reinstate the plan or make payment arrangements.
Automation with RCM
The revenue cycle management process allows for electronic claim submission and remittance payment posting. Automated posting saves the front desk workers alot of time, which permits time for following up on overdue balances and outstanding claims.
To reach a zero balance, the staff must automate tasks that do not require the biller’s expertise. Another way to shorten the revenue cycle is to offer the patient an online bill payment system and e-statements. This saves the practice on mailing statements and the cost of paper and manpower.
Improving Access Management and Responding to Consumerism
The medical billing company should use financial clearance solutions to determine insurance eligibility and the willingness and ability for payment of healthcare costs. Medical necessity should be assessed during registration to reduce Medicare denials and increase reimbursement. This facilitates workflow and eliminates the “paper chase.”
Self-service is now a part of the consumer’s daily life. Access to healthcare portals are commonplace in today’s medical environment. Some of the options with medical billing systems that employ RCM include allowing patients to research healthcare costs, receive online statements, make payments, and schedule appointments.
Accelerating Cash Collection and Payor Performance
With an effective billing company, the revenue capture is maximized and billing/collections is streamlined. This occurs through electronic claim processing, automatic secondary billing, direct entry of claims, remittance posting, contract and denial management, document image retrieval, and financial analysis.
A healthcare organization can manage and monitor payor contracts through web-based analysis and better reporting. A billing company will use sophisticated cost accounting tools to provide detailed patient information to allow the provider to analyze contract performance and manage revenues.
Healthcare institutions must seek out strategies to improve their revenue cycle performance, and improve access management, collections, and payor performance.
There are many benefits to using RCM systems in the medical industry. Those that have used these systems have seen increased revenues and have better managed practices. Implementing this type of system helps maintain accurate records and helps medical practices to be fully aware of their financial status at all times.
MPMR is a top medical billing company with a national footprint. The company works with physicians along with ambulatory surgery centers, and has been helping clients increase revenue substantially for over a decade. They use the top medical billing software options.
Call MPMR today!