4 Key Components of Medical Revenue Cycle Management

Revenue cycle management in a medical practice or facility usually requires the involvement of much of the practice’s staff. Revenue cycle management can get very confusing and unorganized, especially in today’s healthcare world. The Affordable Care Act and upcoming ICD-10 codes are going to add steps and compliance oversight to the already confusing revenue cycle management process. The question is… How do physicians and medical practice staffs battle the chaos and tighten their revenue cycle management processes, when it seems like a new step or regulation is being added every day?

What does Revenue Cycle Management entail?

Today, revenue cycle management has become more of a process than it has ever been. There are many different procedures and tasks that must be taken care of for a practice to run smoothly and stay in business. Here are some of the tasks that must be accomplished in successful revenue cycle management:

Create schedule and patient charts

Collect patient medical info/Update

Verify patient insurance

Maintain HIPAA compliance

Collect balance/copay

Complete patient exam with satisfaction

Document the visit

Close out patient visit

Referencing new and updated charge sheets

Submit accurate claim

Monitor claims process

Receive payment

Deal with denial process

Appeal/Resubmit claim

Monitor appeal and denial process

Send patient billing statement

Recoup any outstanding balances from patient

Components of Successful Revenue Cycle Management

Experienced Staff- An experienced staff is probably the most important component of maintaining an efficient revenue cycle. This staff must be skilled and knowledgeable in healthcare changes, medical billing and coding, insurance claims process and the challenging denial appeals process. Your staff must also have the time to accomplish these tasks with accuracy while still managing other medical practice operations.

Efficient Workflow Process- Having a solid workflow is also essential to making sure your practice has a constant revenue stream. While having a skilled staff is extremely important, knowing where and when to focus that staffs’ skills saves time and money.

Capable Electronic Health Records (EHR) System- Making sure that you and your staff is equipped with the best EHR system for your practice is very important. This technology can make you and your staffs’ lives easier by providing the information you need without disrupting the workflow.

Willingness to Learn/Adapt- With the healthcare industry undergoing drastic changes, physicians and their staffs must be prepared to change and adapt when necessary. Sometimes, this may mean getting rid of an old revenue cycle workflow, and implementing something new.

 

Third Party Revenue Cycle Management

 

Applied Medical Systems (AMS), located in Durham, NC, provides third party revenue cycle management services to medical practices across the nation. We allow physicians and their staffs to get back to providing excellent patient care and experience, rather than worrying about billing. Our professional medical billers and coders have extensive experience with revenue cycle management and all billing and coding processes. To see how we can improve your revenue cycle management, contact us today.