In any scope of work there is always room for improvement. Revenue Cycle Management being the backbone of healthcare industry has continuous room for improvement with the ever changing revision of Medical procedures, technological developments and Insurance policies. The unceasing changes and updates in the healthcare industry and the revenue cycle management process requires Providers, Medical staffs, medical billers and coders to be up to date to keep the physicians practice and the billing process intact.
Revenue cycle management is not just about entering and submitting claims, an efficient revenue cycle management services starts right from the time the patient seeks appointment and goes on until the physician rendering the service is reimbursed with the allowed amount successfully. The cycle includes step by step process of scheduling, Patient registration, Insurance eligibility and benefits verification, Patient Demographics, Coding and Billing, Charge Entry, Claims submission, Payment Posting, AR follow up and Denial Management. Let us discuss in details some key areas which can pull down your chances of claim getting paid at the first submission and some tips to improve them.
Dedicated and Skilled Team of billers and Coders
To run the billing process effectively and productively, a dedicated team to handle each scope of service efficiently is indispensable. Skilled and experienced team of billers and coders can ensure reduced claims denials. A dedicated team of AR follow up will ensure to bring back denied or lost revenue. On the whole having an efficient team to handle the entire billing process is the key to keep the cash flow unimpaired.
Insurance Eligibility and Benefits verification
Verification of each patient’s insurance coverage and benefits is vital as these information will help the provider communicate the patient’s responsibility during the first visit and handle the procedure suitably. Insurance policies and guidelines keep changing so it is important to know if the service to be rendered is covered under the patient’s current insurance policy. Similarly it is also essential to be aware if the patient has paid his insurance due to avoid loss of payment. Research confirm that 90% of claims denials are because of rendering patient service without proper and accurate insurance information.
Denial Management
Neglecting denied and rejected claims can cause unpredictable financial drain on your practice. Lack of proper insurance coverage, incomplete or inaccurate claims documentation, medical billing and coding errors, incorrect charges or demographic entry etc. are few reason for claim denials. Submitting cleaner claims and getting them paid at the first submission requires experienced team of billers and coders who are updated with the constant changes in the billing process. An experienced and dedicated denial management team should be able analyze your billing process and appeal for the missed and lost revenue.
Utilizing Latest Technologies
To meet the demands of the changes in the Healthcare and Medical billing industry, the technological industry has been contributing various updated advancements to improve and ease revenue cycle management service. Choosing the right platform that suits your requirement will help smoothen your medical billing process.
Outsourcing Revenue Cycle Management
Physicians and Practices are at loss looking at their hiked account receivables. While their core responsibility is patient care, many physicians and practices fail at effective billing thereby missing on cash flow through various loop holes. As mentioned above the reason for delay, denied and rejected claims can be varied. Identifying the reason for lost or denied revenue can be time consuming and painstaking. This is one major reason why majority of the physicians agree outsourcing to be the best option for a productive revenue cycle management.
And outsourced medical billing team have the experience and expertise handling every scope of services for you effortlessly. The outsourced medical billing team is well trained to keep themselves current to efficiently handle your claims and increase claim first pass rate. The outsourced medical billing company is fully equipped with the latest technology to ease and smoothen delivery of end to end billing cycle to its client.
About MGSI:
MGSI has over 25 years of experience providing revenue cycle management solutions to physicians, physicians group, hospitalist etc. MGSI has expertise in billing 25+ specialties in multiple states across the country. MGSI strictly follows the information security guidelines in order to protect the confidentiality of patient information as mandated by HIPAA and has been certified by LIVE Compliance as it relates to its network security, employee training and all PHI matters. For further details about MGIS pls. log on to www.mgsionline.com.