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Best Practices in Revenue Cycle Management 2020

Best Practices in Revenue Cycle Management 2020Today, most medical practices are barely getting financed. Decrease in reimbursement payments from government and private payers, along with operating costs on the rise are causing many practices to lose income. Resulting in lower pay salaries for office staff. Collecting every last dollar earned through medical billing services can be challenging and essential for future survival and success of medical practices. Today, with revenue cycle management medical billing, the days of inefficient billing practices are long gone. Simply put the revenue cycle management process in medical billing will help make every dollar count for your practice.

The causes of billing inefficiencies are numerous, and can range from IT related resource constraints, ineffective billing processes, lack of task automation or even lack of expertise or trained staff. In order for your practice to survive and thrive, you must overcome these hurdles and close the gap between revenue earned and revenue collected by using a reliable revenue cycle management medical billing software. There are many practices in revenue cycle management for the year 2020. These best practices can help you optimize every area of your revenue cycle management process within your medical billing.

Keeping your Medical Appointment Schedule Productive

With the increasing number of patients in US, healthcare providers have had to rethink their business practice models and think of a different approach to develop a trust worthy relationship with their patients. One way a revenue cycle management medical billing software can help is that it allows a patient to conveniently schedule and reschedule their appointments.  Thus, allowing patients the freedom to schedule their appointment at their convenience.  All while allowing a physician to choose how many patients he or she sees in a day.

In the past, the purchase of medical insurance and financial decisions in healthcare were made with arrangements and agreements between payers, providers, and the employers. Unlike other consumer markets in US where the consumer has the power.

With the trend shifting, consumer in healthcare is becoming absent due to the absence of intuitive changes for example:

High Conclusive Health Plans

Consumers may experience an increase in their healthcare deductions as healthcare plans today have an average deductible of $1000. This encourages people to demand more improved visibility of healthcare costs and prices, and quality to help them look for better healthcare services. More and more healthcare providers look for quality medical revenue cycle management services to improve upon their decision support, advocacy and other ancillary billing services which have become a market standard in the healthcare industry.

Insurance Exchanges

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 is hard and difficult for patients to schedule an appointment. For example, patient must call the front desk staff  of the practice in order to schedule an appointment during business hours. This can present many frustrating obstacles, such as being placed on hold, your call going to voicemail and having to wait for a call back voicemail or in some instances a patient’s initial registration process may take 5-10 minutes. Simply put, patients hate the process.

By leveraging today’s medical billing software platform and revenue cycle management best practice methods, patients can get access to online medical appointment schedules, which make the whole process of scheduling appointments simple and convenient. Healthcare professionals and patients similarly appreciate convenience when it comes to capturing key information of patient data through this process, such as patient name, address, email, phone details and much more. Furthermore, physicians and staff members can engage with patients more easily with up-to-date contact information for follow-up information such as practice updates, vaccinations, etc. Online appointment scheduling also drives patients to your website, where they can find additional information on the healthcare providers expertise, services provided, directions and other valuable resources important for the patient.

Collecting Payments from Patients

Medical practices in today’s era need to develop essential competencies in the healthcare revenue cycle management market. Most importantly, practices need to be proactive in collecting payments from patients. Insurance payments are unlikely to cover the full cost of the medical services provided. It is important to understand that the patient payment is the main source of profit in a medical appointment visit, yet practices are only able to collect 50% of what is owed from patients.

It is necessary to understand the patient’s responsibility and to have the adequate skills and medical billing software tools to collect co-pays, co-insurance, and deductibles during the visit. Co-pays, co-insurance, and deductibles are critical aspects of payments. In order to collect patient payments, it is crucial that the practice have correct and current information regarding the patients responsibilities and if there are past due balances which are owed.

Automating Patient’s Eligibility through Medical Billing Software

It is surprising to know that 25% of claim denials occur due to patient’s ineligibility for medical insurance benefits. Seeing a patient without confirming his/her medical insurance information can be a huge risk for nonpayment. Patient’s payment coverage may change from visit to visit. It is important to ensure active coverage to prevent ineligibility which ultimately results in claim denials, identifying accurate co-pays and other deductible amounts.

The problem of checking or verifying patient insurance eligibility through web or online platforms, can be a long and exhausting process. It can also be expensive if your practice has to pay for each transaction through a traditional practice management system or clearinghouse, which is not considered as 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 for physician practices, you can enable your practice to automate the process of eligibility verification. You can ensure correct and accurate patient eligibility and early collections of patient payments. By automating patient eligibility verification, you can have 24/7 responses, access verifications in real-time, create reminder flags and alerts to identify or capture errors in the appointment scheduling process.

Patients must understand their payment responsibility from the beginning for all services being offered. With the use of modern practice management revenue cycle software tools, it becomes easier to verify patient insurance, initial coverage, notification of estimated cost of services,  patient information and help patients understand the terms and schedule of their payments so that  there is no confusion.  This will improve patient payment results while allowing the physician to continue to treat and care for the patient as needed.


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