Here is why you need an established RCM tool

When it comes to medical institutions the first thing that comes to our minds are hospitals, clinics, small practices, or larger healthcare systems and we instantly link them with their healthcare services and health related processes, however we may always forget about their financial and administrative side of these institutions.

We certainly know that treating patients and saving lives are the priority but at the same time we need to develop efficient processes and policies to remain financially healthy so here is where the healthcare revenue cycle management (RCM) comes in.

RCM unifies the business and clinical sides of healthcare by coupling administrative data, such as a patient’s name, insurance provider and other personal information, with the treatment a patient receives and their health data.

Although managing revenue is the key for any business to keep running, it is not the primary focus of healthcare providers so RCM enables healthcare organizations to be able to afford medical supplies, salaries, equipment, structural improvements, and more. Without this critical financial process, these institutions cannot keep their doors open to treat patients and save lives.

A streamlined and efficient revenue cycle is one of the pillars of a successful health care organization. However, one that lacks efficiency, properly trained staff, and effective denials management can negatively impact the healthcare facility’s bottom line.

The revenue cycle includes more than just ensuring the end balance on any account is zero. It starts when a patient calls to make an appointment and ends when all outstanding payments are collected. There are many steps that need to be taken from the very beginning to ensure that nothing goes wrong. Failure to capture insurance information while setting up an appointment, for example, could lead to wasted time and resources when it is discovered that a patient’s insurance is not accepted.

On many occasions, and because each case is different, claims can go back and forth between payers and providers for long periods until all issues have been resolved and the service is paid, not to mention that patients do not always have the funds available to pay medical bills immediately. The idea with RCM is to properly identify points of friction causing these delays and then resolve them as quickly as possible to make the financial process of healthcare organizations as efficient as possible.

Having the right partner to take care of all these details to ensure that your billing process gets done properly the first time and boost your productivity, avoiding denied or delayed claims is our main goal as Medical billing specialists. Our 13 years of experience has taken us to master medical billing solutions, resulting in superior outcomes for our partners.