Claims & Collections: Don’t Leave Revenue on the Table

RCM Process

One of the most difficult years ever for the healthcare industry is slowly drawing to a close. A few months from now, the yearly financial reports will undoubtedly show that uncollected payments and arrears accounts were among the highest costs to healthcare providers. With the cost of healthcare consistently increasing faster than millions of Americans’ income, this really shouldn’t come as a surprise. But without your patients paying their bills, you can’t keep your practice open, so you have to find a way to boost claims and collections. 

How You Can Improve RCM for Your Practice

What can you do to contain costs and improve cash flow while at the same time improving patient experience? Everything starts with a better understanding of — and improved control over — the revenue cycle management process.

Let’s take a closer look at what areas should be improved to make this happen. 

  1. The Whole Claims Process

Keep a pulse on the claims process throughout its life cycle. Failure to monitor claims closely makes it harder to eventually determine where and when a mistake was made. 

For example, it’s a good idea to set up an automatic alert when an insurance payer denies claims for a particular code or procedure on a regular basis. Without that, staff may routinely spend many hours researching these types of issues instead of attending to other important work, which slows down productivity and revenue. 

  1. Patient Communication

It’s a struggle to collect payment from patients after they’ve walked out the door, which is why it’s so important to master the art of communicating with patients before or even at the time of service. When patients fully understand services rendered and the costs that are involved with them, they can decide if it’s something they want to do and pay for, and then it’s much less likely that you’ll be left with an unpaid bill down the road. 

  1. Accuracy with Billing and Collections

Bills that contain incorrect or incomplete information cost millions of dollars every year. Sometimes, a seemingly insignificant clerical error, like miscoding a particular procedure or incorrectly spelling a patient’s name, can cause a ripple effect when the bill is sent for collection or to the insurance payer.

Healthcare is a busy, stressful field. Mistakes may be made on occasion in the midst of the hustle, and you have to recognize that if people are doing the work, there will be errors; however, it’s important to stress upfront how critical accuracy is, and explain the disastrous consequences that can result from even a small mistake.

This brings us to the next point…

  1. Staff Training

No matter what time of practice you run, under-trained or untrained staff can cause havoc as far as the RCM process is concerned. We’re talking serious issues that can destroy your reputation and revenue. A staff member who fails to correctly capture a patient’s information can make it impossible to successfully create and collect an insurance claim.

Apart from coding and billing issues, an untrained staff member can contribute to mistakes in medical documentation that might result in lost revenue, or even penalties. To name just one example: In 2015, at least 23 hospitals in New Jersey had to pay a hefty $500,000 penalty after being found guilty of making medical errors. That’s not something you want to happen to your practice, and should be avoided at all costs — literally.

That is why coding staff, in particular, should complete training sessions to help them master the art of effective coding. Of course, that costs money, but a well-trained staff member is an investment in the reduction of costly billing errors. You’ll more than make that money back if your staff is doing their jobs correctly. 

  1. Updated Technology

Technology can make a big difference in the outcomes of your practice, and if you invest in the right technology and training, then your team can directly use top-of-the-line medical billing and coding systems to produce good results. Similarly, if you choose to outsource it by working with a professional healthcare RCM company who relies on their own working systems, you can expect to minimize errors and maximize profits for your practice. 

See How Professional Healthcare RCM Services Can Help Improve Cash Flow

At Ultimate Billing, we know the RCM process is complicated and overwhelming, especially when it comes to claims and collections. Our team is skilled in medical billing services and can quickly turn around your numbers in no time so you can experience an increase in revenue for your practice. To get more information, contact our team today for a quick consultation.

Related article to learn more about improving your RCM process: 5 Strategies to Reduce Your Claim Denials

Ultimate Billing exists to reduce the business burden of healthcare, allowing our clients to focus on patient care.

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