Keys To Improving Your Revenue Cycle – Food, Drugs, Healthcare, Life Sciences

Revenue cycle management (RCM) is one of the most complex
medical office tasks. There are layers of steps involved in the
process and roadblocks may be encountered throughout the entire
process. Luckily, there are ways to apply the standard principles
of professional RCM to improve your office’s ability to get
paid in a timely manner.

Related Read: How’s Your Revenue Cycle?

Here are five ways to help evaluate your RCM:

1. Utilize the Entire Team
   Everyone in the practice plays a vital role in the
   successful submission of insurance claims. The process really
   starts the moment the patient calls the office. Obtaining the
   patient information, processing insurance cards and documenting all
   necessary information can and should be performed before the
   medical professionals even see the patient.




2. Avoid Rejection
   About a third of claims are rejected over eligibility
   issues. However, utilizing the available technology can minimize
   and even eliminate this issue. Your electronic health record (EHR)
   system should have this capability. Eliminate this problem on the
   front end to allow for successful payment on the back end.




3. Keep the Patients
   Educated
   It is very uncommon for patients to be fully aware of the
   details of their policy and what may or may not be covered. It is
   important that your practice educates and informs patients of what
   patients owe and when. Communicate possible co-pays or other costs
   a patient may be liable for early on.




4. Perform Internal Audits
   Quite often revenue is lost merely from the fact that
   billing never went out. It is best practice to examine this at
   least twice a year through an internal audit. Questions to consider
   include:
   • Are services being paid on
     time?

   
   

   • Do the services match the
     patient’s explanation of benefits?

   
   

   • Are the write-offs being applied
     appropriately and the balances corrected as necessary?




5. File Claims on Time
   Some funding sources have expiration dates of when claims
   can be filed. Do not miss a filing deadline as this will
   automatically create a loss of revenue. Evaluate and monitor the
   time each step takes, from the time the patient attends the
   appointment to the moment the claim is submitted, posted and
   billed.

Getting the most out of your revenue cycle is incredibly
important. Identify where issues may arise. Being proactive is the
key to obtaining your maximum potential. Do not miss out on lost
revenues, especially if you put in all of the work already.

Related Read: Help Your Bottom Line: Focus on Your Revenue
Cycle

The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.