Optimize Your Revenue Cycle for Maximum Performance
Protect the integrity and overall health of revenue coming into your organization. Our RCM experts help verify and improve your revenue cycle management process to reduce recoupments, fines, and penalties.
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What Is Revenue Cycle Management in Healthcare?
Revenue Cycle Management (RCM) is the medical billing procedure that streamlines the reimbursement process for healthcare services given to patients. It covers everything from an individual's initial service to the receipt of payment for each service.
Effective RCM requires a strategic approach to optimize financial performance. By focusing on the key elements of registration, coding, and billing, medical practices can reduce costs and improve revenue, ensuring financial stability and a better patient experience.
Physician-based organizations have a lot going on at once. With DoctorsManagement, your organization can verify and better understand the reliability of the revenue cycle management process to implement needed stop gaps that protect incoming revenue.
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How Revenue Cycle Management Works
The revenue cycle process in healthcare follows a specific sequence from patient registration through final payment collection.
Patient Registration
The first step is demographic intake and proper entry of data including the patient's name, address, and insurance information. Incorrect entries impact claim accuracy, which may lead to denials. Reliable staff ensure information is up-to-date at every encounter.
Medical Coding
After each patient encounter, a code is required to properly convey performed services to the payer for reimbursement. Whether medical coders or providers handle coding, correct and thorough coding is vital to claim payment and associated reimbursement.
Medical Billing & Collection
Services are ready for claims creation and submission. The billing team may add reviews through claim scrubbing before submission. Post-submission work includes rejection reprocessing, denial management, and patient collection for coinsurance, claims responsibility, and deductibles.
RCM Analysis Findings We Address
Our expert analysis identifies these common issues that lead to improvement plans and educational training.
Pristine AR with Low Reimbursement
Clean accounts receivable coupled with lower-than-average reimbursement percentages.
High Outstanding AR
High outstanding AR that lacks a plan or process for reduction and resolution.
High-Volume Denials
Recurrent and high-volume claim denials that bottleneck revenue flow.
Payer Relationship Issues
Perceived payer prejudice necessitating evaluation for out-of-network migration.
Lack of Standards
Missing standards or processes for repeatability and consistency.
Prior Authorization Impacts
Prior authorization and certification issues impacting revenue cycle flow.
Importance of a Revenue Cycle Analysis
An RCM expert on your side can assess the process, performance, efficiency, and thoroughness of your RCM to maintain sustainable revenue for your organization.
Verify Sustainability
Accuracy, standards, and repeatability of procedures increase long-term sustainability. RCM is a revenue throttle for your organization; if blocked or lacking integrity, incoming revenue may be paralyzed.
Make Educated Decisions
Payer policy dictates claims reimbursement. Understanding your payers and their performance significantly impacts financial viability. Analysis provides spotlight on problematic payer relationships.
Improve Collections
For many in the RCM industry, billing has been a learned trade through on-the-job training. However, working toward creative claims resolution processes leads to better outcomes. Each team member must know the best approach to resolving each claim. An RCM analysis provides resources and training opportunities that lead to better claims processing with improved collections.
Reduce Errors
Denials are costly to an organization, as they require reworking claims that could have led to reimbursement on first submission. However, clean claim costs can also be burdensome. Finding the right balance of work for each can be best identified through the findings and recommendations of an RCM analysis.
What You Achieve with RCM Optimization
Partner with DoctorsManagement to transform your revenue cycle and experience measurable improvements.
Better Patient Satisfaction
Streamlined billing processes improve the patient financial experience.
Reduced Compliance Risk
Proper processes minimize audit exposure and regulatory concerns.
Improved Revenue
Optimized processes lead to better collections and reduced denials.
Stress-Free Environment
Peace of mind for physicians and staff with reliable processes.
Expert RCM Consulting Services
At DoctorsManagement, we have experts who can provide comprehensive RCM analysis and offer a plan for improvement. Your RCM process will be evaluated from claim inception through the collection procedure.
Comprehensive Analysis
We evaluate your entire RCM process from claim inception through collection, identifying gaps and opportunities for improvement.
Implementation Support
Our expert creates a plan and assists in its implementation to ensure improved performance, including team development and training.
Ongoing Oversight
When needed, we provide ongoing RCM oversight to ensure sustained performance and continuous improvement.
Our RCM Services Include
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Ready to optimize your revenue cycle? Contact our team to discuss your RCM challenges and receive a customized analysis proposal.
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DoctorsManagement does not work with patients. We offer support to medical practices.
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