The US healthcare system is changing how it operates, moving away from charging for each service and focusing more on providing valuable care. However, it is currently wasting a lot of money on handling medical bills and managing costs and income. This wastage will continue until the transition is complete. The problems in the system are especially concerning when it comes to how payers, providers, and patients interact.
A report from CAQH in 2016 stated that using manual billing systems can lead to revenue cycle problems, which means that 15 cents out of every dollar earned is lost. Healthcare practices also lose money, around 5-12%, due to denials, unsuccessful negotiations, and not getting paid enough. Thankfully, healthcare providers are becoming more aware of the benefits of using advanced Revenue Cycle Management Solutions. Also, they are realizing the value that these systems bring and are using them to improve and simplify their income management.
Why You Should Use Specialized RCM Solutions
Getting paid for your services involves managing your healthcare practice’s financial operations. Further, Revenue Cycle Management (RCM) is really important for healthcare practices because of a few reasons:
- The cost of collecting payments needs to be lower.
- We need better technology to avoid problems with operations.
- Specialized expertise is required for high-value claims.
- We’re losing a lot of revenue due to underpayments.
- We need to negotiate payments with insurance companies more effectively.
- New practices need to start making money quickly.
What Are The Several Benefits Of Specialized RCM Solution?
Improved collaboration
When billing is done correctly, it helps with communication within and outside the business. This reduces the gap between the business and clinical aspects. As a result, all departments can work together effectively.
Business Intelligence
Certain advanced RCM solutions include tools for business intelligence and ad-hoc reporting. These tools also help to analyze data and make fast and well-informed decisions.
Efficiency
Using reasonable RCM solutions along with EHR, practice management, and patient portals can significantly reduce communication problems, operational delays, and lower quality of service. Also, this helps to avoid doing the same work twice, making mistakes, and spending more money on collecting payments.
Data Cohesion
RCM solutions handle finances well and connect administrative and clinical information. This includes a patient’s demographics, clinical details, and insurance information.
Informed Patients
High-quality RCM solutions have self-service features like patient portals. These portals give patients access to the latest account information. Patients can find out about claim amounts, outstanding balances, and insurance details directly.
Better Claim Handling
By outsourcing billing to an expert and automated system like Medical Billing Services in Illinois, healthcare providers can save money. This is because they reduce denied claims that often occur due to manual processing. On average, the denial rate can decrease by 4-7%. Moreover, providers can benefit from increased reimbursement rates, leading to a faster revenue cycle for their practice.
Reduced Billing Errors
Experienced specialists bring valuable knowledge and expertise. A specialized billing system with trained staff and advanced technology avoids mistakes like incomplete patient information, incorrect amounts, or wrong codes. Furthermore, this speeds up payment and reduces time spent on staff training.
Staying on Track with the Industry
If your practice faces financial problems because of manual billing processes, you likely need to catch up to the rest of the industry. By using a specialty-specific RCM solution, you can keep up with ICD code changes, insurer policy updates, and incentive programs. A specialized medical billing organization can handle these tasks much better than the staff in a busy medical practice.
Enhanced Cash Flow
Independent medical practices often assign one person to handle billing processes, which can lead to errors, delays, and disruptions in cash flow. A specialized billing service has a dedicated team that ensures continuous, smooth, and timely handling. On average, it increases the number of days with cash on hand by up to 22 days.
Streamline billing process
A specialized RCM solution can help Primary Care Clinics streamline billing and payment processes and increase overall revenue. It also enables clinics to efficiently manage their finances, optimize reimbursement, and focus on providing quality care to their patients.
Improved Analysis and Planning
When medical practices make their financial processes more efficient, it becomes easier for them to track progress. They can do this by reviewing billing data and creating reports to evaluate their performance. Reputed RCM systems offer data mining services through analytics tools, which help monitor and analyze revenue trends. Healthcare providers should use these insights to make business decisions and improve their processes.
Improving Patient Service
Using a specialty-specific RCM service brings together various benefits that contribute to the main goal of every medical practice: providing high-quality service to patients. Finances can be overwhelming for many practices, and this can hurt your focus on patient care. By taking care of cash flow and other administrative tasks, providers can shift their attention and time towards value-based care, giving more focus and attention.
Final Thoughts
The right tools, technologies, and processes can help improve patient care and cash flow in a healthcare facility. Further, this can happen through the evolution of a specialized RCM solution. It also ensures that critical resources are not compromised.
