Today, most medical practices are struggling to secure financing due to a decrease in reimbursement payments from the government and private payers, as well as rising operating costs. This financial strain is resulting in lower pay for office staff. Collecting every last dollar earned through medical billing services can be challenging but is essential for the future survival and success of medical practices. Fortunately, with revenue cycle management in medical billing, the days of inefficient billing practices are long gone. In simple terms, the revenue cycle management process in medical billing will help ensure that every dollar counts for your practice.
The causes of billing inefficiencies are numerous and can range from IT-related resource constraints to ineffective billing processes, lack of task automation, or even a shortage of expertise or trained staff. To ensure the survival and prosperity of your practice, you must overcome these obstacles and bridge the gap between revenue earned and revenue collected by using reliable revenue cycle management medical billing software. There are several best practices in revenue cycle management for the year 2024 that can help you optimize every aspect of your revenue cycle management process within your medical billing.
Keeping your Medical Appointment Schedule Productive
With the increasing number of patients in the US, healthcare providers have had to reconsider their business practice models and adopt a different approach to establish a trustworthy relationship with their patients. One way in which revenue cycle management medical billing software can be of assistance is by enabling patients to conveniently schedule and reschedule their appointments. This grants patients the flexibility to set their appointments at their convenience, while also allowing physicians to manage the number of patients they see in a day.
In the past, decisions related to medical insurance and financial matters in healthcare were made through agreements and arrangements involving payers, providers, and employers. This is unlike other consumer markets in the US, where consumers hold more power.
However, the healthcare landscape is undergoing a shift, and consumers in healthcare are becoming less involved due to the lack of intuitive changes, such as:
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High Conclusive Health Plans
Consumers may experience an increase in their healthcare deductions, as healthcare plans today typically have an average deductible of $1,000. This encourages people to seek greater transparency in healthcare costs, prices, and quality, empowering them to search for better healthcare services. An increasing number of healthcare providers are now seeking quality medical revenue cycle management services to enhance their decision support, advocacy, and other ancillary billing services. These services have become a market standard in the healthcare industry.
With an increase in healthcare costs, employees are starting to choose insurance exchange markets. Payers must change their approach away from simply selling services to a structure that meets the consumers demands
New Payment Reimbursement Models for Healthcare Professionals
With bundled payments, providers are not being held responsible for the quality of care they are providing, but they must also involve significant financial risks associated with consumer decision making process. With a seamless revenue cycle management process in your medical billing, you can make your practice more intuitive for patients to understand the value of your services and schedule their appointments easily and effectively.
Setting Medical Appointments
In some practices, it can be challenging for patients to schedule an appointment. For example, patients must contact the front desk staff during business hours to schedule an appointment, which can lead to frustrating obstacles such as being placed on hold, calls going to voicemail, and having to wait for a call back. In some cases, a patient’s initial registration process may take 5-10 minutes. Simply put, patients dislike this process.
By leveraging today’s medical billing software platform and implementing best practices in revenue cycle management, patients can gain access to online medical appointment schedules, simplifying and streamlining the appointment scheduling process. Both healthcare professionals and patients appreciate the convenience of this approach, as it allows for easy capture of crucial patient data, including patient names, addresses, email addresses, phone numbers, and more. Additionally, physicians and staff members can more easily engage with patients using up-to-date contact information for follow-up purposes, such as providing practice updates or vaccination information. Online appointment scheduling also directs patients to your website, where they can find additional information about the healthcare provider’s expertise, services offered, directions, and other valuable resources that are important for patients.
Collecting Payments from Patients
Medical practices in today’s era must develop essential competencies in the healthcare revenue cycle management market. Most importantly, practices need to proactively collect payments from patients. Insurance payments are unlikely to cover the full cost of the medical services provided. It’s crucial to understand that patient payments are the primary source of profit during a medical appointment, yet practices often collect only 50% of what is owed by patients.
Understanding the patient’s responsibilities and possessing the necessary skills and medical billing software tools to collect co-pays, co-insurance, and deductibles during the visit is essential. Co-pays, co-insurance, and deductibles are critical components of these payments. To successfully collect patient payments, the practice must maintain accurate and up-to-date information about the patients’ responsibilities and any past due balances owed.
Automating Patient’s Eligibility through Medical Billing Software
It is surprising to learn that 25% of claim denials occur due to a patient’s ineligibility for medical insurance benefits. Seeing a patient without confirming their medical insurance information can pose a significant risk of nonpayment, as a patient’s payment coverage may change from one visit to the next. Ensuring active coverage is vital to prevent ineligibility, which ultimately leads to claim denials and accurately identifying co-pays and other deductible amounts.
The process of checking or verifying patient insurance eligibility through web or online platforms can be time-consuming and tiring. It can also become costly if your practice has to pay for each transaction through a traditional practice management system or clearinghouse, which is not considered one of the best practices in revenue cycle management.
Implementing Sophisticated Revenue Cycle Management
With the implementation of a modern and sophisticated revenue cycle management system for physician practices, you can automate the process of eligibility verification, ensuring correct and accurate patient eligibility and early collection of patient payments. Automating patient eligibility verification provides 24/7 responses, real-time access to verifications, and the ability to create reminder flags and alerts to identify and rectify errors in the appointment scheduling process.
Patients must have a clear understanding of their payment responsibilities for all services being offered. By utilizing modern practice management revenue cycle software tools, it becomes easier to verify patient insurance, initial coverage, provide notifications of estimated costs of services, collect patient information, and help patients comprehend the terms and payment schedule, eliminating confusion. This will enhance patient payment results while allowing the physician to continue treating and caring for the patient as needed.