Revenue Cycle Management – 5 Ways in Which Related Issues Can Be Tackled

The Healthcare Financial Management Association (HFMA) defines revenue cycle as “All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” In other words, ‘Revenue Cycle Management (RCM)’ is the process of the creation of a patient’s payment account to the actual payment. A practice can be successful only if all the major components related to your billing services are in place. Excellent skills and practices are required to tackle medical billing issues. Services can be improved in the long term by enhancing a few parameters.

Financial performance and reporting:

Improve your cash flow with detailed reporting systems and quick turnaround times. Claims if denied, need to be corrected and resubmitted at the earliest. Allowance of electronic transfer of funds and payment posting will enhance the financial performance of the medical billing services. Include conciliation reports in your system to manage daily transactions.

Billing practice and back office activities:

As billing and payments take time for processing, ensure that claims are submitted on time and quickly. It is also required that processes are monitored at regular intervals and new strategies are invented regularly for scaling up the services. Gather as much data as possible with precision the first time the patient reaches the hospital. It allows for a hassle free dealing at the next visit of the patient.

System flexibility:

Have all the information on a spreadsheet ready so when a patient calls, accessibility and accuracy to the information is quick. Ensure that an automated claim filing system is in place so as to accelerate reimbursements. Have a system which can indicate unpaid claims of 30, 60, 90 and 120 to reduce the outstanding payments Ascertain that the system supports formats ANSI 837 and CMS 1500.

Efficient technology:

It is important to be up to date with the scheduling software and the billing applications. Make it a one stop integrated solution which allows auto posting of insurance payments from practice management software. Maintain all compliances. Make certain of a follow up on A/Rs. Make the system web-based and accessible 24/7 to allow accessibility to information anytime along with the ability to pull reports or invoices.


Implementation of the process of signing the ‘Credit Card Authorization Form’ ensures the elimination of A/Rs and recapturing the out-of-pocket (OOP) expenses. This safely secures credit card details and makes things hassle free for patients as it avoids them from calling the clinic to make payments. In addition, it increases overall customer satisfaction.

Medical billing and coding is not straightforward. Complete RCM services for any specialty empower medical practitioners to acquire every dollar, thereby improving cash flow. This also aids in reducing administrative burdens thereby allowing the physician to focus on complete patient care.

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Intro to Your New Medical Billing Position, Listen and Learn

Medical billing is evolving all the time. Sometimes it doesn’t feel like it but it is. Some new policy or plan, but there is always something going on outside of your job all the time.

There is still more to learn, even after all of your training. All of your note taking and seminars seem to have given you an immediate sense of completion but there is more. Even after you think that you have mastered your errors and lowered your error rate. Your boss isn’t speaking to you regarding the same issues at this point, there are no new complaints. It does not mean that you have mastered everything that pertains to your position of medical biller. I know you are tempted to just go on and do what you think is best. It’s not wise. Instincts are great, but coupled with proper knowledge, they are awesome.

Even the most seasoned medical biller has the potential to learn something new everyday. Some nugget of wisdom, some subtle nuance that will assist in bettering you for your future. So when your boss is talking to you about something that pertains to your position; while you want to be engaging, stop talking and listen period. This is a learning opportunity and besides you both can not speak at the same time because something is sure to be missed. Above that it’s just rude to over talk your employer when they are in a discussion with you anyway. How hard can it be to just wait until he or she is done with their portion of the conversation? Then you can respond or comment and possibly get a better understanding. Otherwise you very well may miss that one thing that could help you the next time on something very important. The last thing you will want do is go back to your boss and ask questions regarding something that you were supposed to be listening to in the first place. You then come off as inattentive and uninterested. It takes less to time listen and get the details needed than it does to try something, second guess yourself start over and ask an already answered question. Not to mention the fact that dependent upon the subject matter, your boss is now second guessing you being in your position.

Listen, no one can know everything, this industry is always moving,changing and evolving. We have just transitioned to a new coding system just as this article is being written. As I type some new processing rule has just been implemented and some carrier has just decided that they are requiring more specific data for certain codes. Don’t allow something as simple as not taking the time to listen cause you to fall short. Listen learn and grow.

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10 Signs You Should Invest in Outsourcing Medical Billing Services

Most hospital CFOs and Health Information Managers are turning to outsourcing, which is another word for subcontracting. Today we face challenging times with ever tightening budgets, unrealistic deadlines, and vast amounts of information that are getting more difficult to manage. The only solution seems to lie with outsourcing most of your tasks, including Medical Billing Services. Here are 10 signs giving a green signal for investing in outsourcing Medical Billing Services.

Better Revenues

What better reason can one look for than increased revenues with minimum effort? What’s more is you are still in absolute control of things like your billing and money as well. With a dedicated outsourced billing staff working around the clock, you get to monitor the work at every stage, thanks to the Internet.

Tight Leash

Although your work is being done offshore by total strangers you still get to keep them in a tight leash. Having control over outsourced work is like having your cake and eating it too. You’ve got nothing to lose, though the only things you lose are a whole lot of frustration and frayed tempers. Having control from a remote location has its own benefits, and what’s more is you can pull up any record at any time of the day or night and make your own notations.

Qualified and dedicated workforce

You get to enjoy the services of a qualified and dedicated workforce, and in most cases you may not have to go through the cumbersome process of recruitment and training. The dedicated team is trained to keep track of all your claims. Their exclusive focus will be on improving and maintaining the financial status of your practice, leading to increased revenues and profits.

Tangible Results

The major advantage of outsourcing Medical Billing Services is that you have the reports detailing the current month’s billing and collections on your table promptly. Simply scanning through the reports you’ll be able to evaluate and calculate the exact amount of money you save every month. The reports will be concise and carry minute details of all aspects of the process. You can call for web-based meetings to thrash out issues, if any.

Safe and Secure

Contrary to popular belief and misconception, it is absolutely safe to streamline your billing and simplify the workflow by outsourcing. Most vendors are transparent and would be happy to render full visibility to the process. What’s more is the process is HIPAA – compliant, assuring the confidentiality of your patients’ charts.

Keeping track of changing regulations

Once the process is outsourced, you don’t have to break your head about keeping track of the ever changing regulations, which can be a daunting task. Simply leave this to the vendors who are trained and have the wherewithal to figure out how to apply new rules and follow the several guidelines, laws, and publications that keeping changing at regular intervals.

Cost cutting

It is increasingly difficult to run a business, what with the cost of billing eating up close to 30 to 40% of billing revenues. Outsourcing Medical Billing Services helps keep costs under control as you save on expenses you’d have to incur on billing staff, extra space to accommodate them and other welfare costs as well.

Saving on Software and Hardware costs

Outsourcing Medical Billing Services helps you save a lot of money that you would have to otherwise spend on expensive software and hardware. Practice management software does not come cheap, and can go up to $200 per month per doctor. Hardware and maintenance costs work up to around $500, whereas these problems do not exist once you’ve decided to outsource.

Saving on Capital Outlay

Everyone knows expensive it is to own a billing system, what with the prohibitive costs of latest equipment and regular upgrades on software. By outsourcing Medical Billing Services you do away with the need to invest on capital for setting up a complex billing system. Outsourcing to experienced vendors helps save on the initial costs involved in setting up a business.

More time for patients

Who wouldn’t want more time to devote to patients? Outsourcing Medical Billing Services ensures that you have more time to focus on core competencies like better patient care. Once the medical billing experts take charge of your billing and insurance processing, you are left with more time on your hands for the most important factor in your practice be the welfare of your patients.

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