Importance of Revenue Cycle Management

All Medical Practices and independent practitioners are seeking the same end result: increased revenue and decreased costs. What’s the best way to reach that end result effectively? Revenue cycle management. While each practice has its own unique billing needs, consistency is required to significantly boost revenue while reducing the rate of claim rejection. Let’s examine each area of your practice.

Front Office

What matters most to your practice’s front office?

  • insurance verification
  • co-pay collection
  • balance reviews.

The great thing is that e-verification, or real-time eligibility, has vastly improved the process of checking patient insurance policies and should be done for all incoming individuals, not just new patients or those who have switched insurance carriers/plans. At the same time, the front office should be responsible for collecting co-pays during the check-in process. Practitioners striving to maximize revenue and cash flow should not assume their patients would eventually pay. Regardless of the size of the co-pay, make sure it’s collected up front. There are plenty of distractions that will jeopardize a patient paying after the visit.

The front office should also be in charge of (or ‘oversee’) balance reviews upon patient check-in. Your front office staff needs to make sure they are collecting outstanding balances with the required co-pay. If a patient is unable to pay the full outstanding balance, making an optimal payment plan available is the next best option. With the right Medical Billing software in place, your front office can immediately retrieve a patient balance, enabling them to explain line by line what each dollar on the statement represents. As much as 30% of a practices’ revenue can be lost by not collecting the co-pay and outstanding balances – factor in the cost of collections and you can see how it snow balls quickly.

Revenue Cycle Management for Medical Practices

Back Office

What matters most to your practice’s back office?

  • coding
  • accounts receivable management

Keeping uptodate with coding is a common challenge for most practices. As medical codes are constantly under revision with new arrivals, major and minor changes, staying ahead can be incredibly tough. The obvious consequence of not staying informed is rejected or unpaid claims. Using the right medical coding software can keep rejected and unpaid claims at bay.

Accounts receivable is basically money owned to your practice by your patients, which is why accounts receivable management is incredibly important to improving revenue. Like every aspect of revenue cycle management, consistency is key. Billing done in-house should be reviewed at a minimum of twice a week. Thankfully today, with the help of efficient medical practice software and medical billing services, your practice can stay on top of outstanding claims efficiently.

Billing Staff

Medical Practices that do their own billing in-house need an incredibly experienced billing staff to manage the entire revenue cycle. The most important thing a Medical Practice can offer their billing staff is continued education into the revenue cycle process. Employing workers who are knowledgeable and up-to-date in medical billing best practices is an absolute must to achieve increased revenue, decreased costs and claim denial rates.

At this point, it’s much more beneficial for a Medical Practice to hire a third-party revenue cycle management company like us, Medical Revenue Solutions. With communication and full transparency being a core value of our business, we are able to focus on increasing your revenue, accelerating cash flow through enhanced efficiency and improving compliance. Shouldn’t you cut yourself some slack and schedule some time that best fits your schedule to chat with us – without any sales pressure, commitments, fee’s or obligations? We understand making the decision to outsource is tough, but we’re here to help you figure out if it’s the right decision for your business.