Best Practices For Your Revenue Cycle Management

For a practice, cash flow is something that constantly stays on top of their mind, as it is the driving force of the practice. Getting paid is as important as patient care or treatment. Taking care of your practice’s revenue cycle is important for the success or growth of your practice. Always keep in mind that the long-term success of your practice depends on the proper management of your revenue cycle, which includes accurate claim submission and timely payment from both the patients and the insurance providers. Required attention needs to be given to revenue cycle management if you want your practice to run smoothly and successfully. Careless revenue cycle management can lead to the denial of claims, resulting in a loss of revenue. Practices often struggle with the management of complex dental RCM processes, with their constantly changing insurance rules and regulations. Delivering top-quality patient care along with all the complex revenue management can be a demanding and time-consuming task for your practice, which can hinder the performance of your practice and its staff. Having said that, learning and improving your RCM is very important for the growth and success of your practice.

So, here are some of the best practices for your RCM 

Accurate documentation of patient details

Do not submit incorrect information about patients. Make sure that you collect accurate information on your patients. Do confirm the data you have collected in case there are any mistakes.  Important information such as the patient’s name, demographics, medical information, and insurance information must be gathered. Any error in the information documented can lead to claim denial, which can create another set of difficulties for your practice and its staff. In addition, make sure you have the complete details on the patients. Incomplete documentation of information can also lead to claim denials.

Check for eligibility and benefits verification before providing any services

It is important that you check the insurance coverage and eligibility of the patients before providing any services. Many practices, in their hurry to submit claims within the given time frame, give less or no attention to proper eligibility or benefits verification, hampering the entire revenue cycle process. A lot of claim denials occur due to mistakes or errors in eligibility and benefits verification. This shows exactly why we need to do proper eligibility verification. Thus, you can improve the revenue of your practice and reduce any unnecessary loss of revenue.

Error-free coding

Make sure that you do the coding error-free before submitting the claims. Proper coding of insurance claims can be a really complex and time-consuming task for your practice staff. Getting the claim accepted on the first try itself is important for your practice, as claim denials can create havoc in your practice. Since it is a complex process, extra attention or care needs to be taken while coding for your insurance claims. Remember, even a tiny mistake in it can cause claim denials, which can delay the entire payment process.

Make the process patient-friendly

It is no secret that patients are the most important aspect of a practice. They determine the success or failure of your practice. Therefore, the main priority of your practice should be to make them feel comfortable and at ease by making the complex RCM process easier and simpler for them. Patients should be notified about their responsibilities and payment options before providing the services so that they know what to expect while availing the services and are not exposed to any surprises. The longer the patient stays confused about the RCM process, the longer it will take for them to make the payment. So it is important to prioritize your patients for a faster and smoother payment process.

Timely submission of claims

Practices  frequently miss the deadlines established by the insurance providers, making late claim submissions one of the most frequent errors committed by practices. It is critical to understand that late submission of claims can result in their denial, making the already difficult RCM process even more difficult for the practice. Make sure that you submit your claims within a given time frame for an easier and faster payment cycle. The longer it takes to submit claims, the longer the payment cycle becomes, increasing the risk of claims going unpaid and resulting in revenue loss.

Effective management of your accounts receivable

Your accounts receivable is the key indicator of how well your practice is working and how well the RCM is being managed. The higher the days in AR, the higher the risk of payment going unpaid. It is highly important to keep your AR days low for the smooth running of your practice and an increase in revenue. Remember, claims with AR days above 90 days are at a high risk of going unpaid. If the AR is not managed properly, then it will affect the overall revenue cycle and can even result in a huge loss of revenue for your practice.

Mitigate and manage denials

Claim denial management is one of the last but one of the most important steps for effective management of RCM. Claim denials are one of the most important and frequent reasons for the loss of revenue in a practice. Denied claims need to be identified and addressed as fast as possible for the maximum reimbursement. The best way is to avoid claim denials as much as possible. The rework and resubmission of denied claims can take a lot of time and effort from your staff and can create a lot of hassles in the revenue cycle. Therefore, it is better to avoid claim denials to the best of your capability. Even if claim denials occur, make sure to address them in a timely manner.

Partnering with an RCM service provider

Revenue cycle management is a complex and demanding process that can take a lot of time and effort from your practice and its staff. As a result, most of the practices often struggle with their management and end up losing a great deal of their revenue. Partnering with an RCM service provider can help you take the extra burden off the shoulders of your practice staff. With an RCM service provider by your side, you can focus your attention on the more important needs of your practice, including patient care and treatment.

Conclusion

Practices often focus their attention mainly on quality patient care and treatment and overlook proper management of RCM, as it is a complex and time-consuming task. But it is important to realize that any error or mismanagement in it can create a huge loss in revenue for your practice. Make sure that you properly manage your RCM for the success and growth of your practice. Opting for an RCM service provider can also be a good step in easily managing your revenue cycle without your staff having to overstress themselves. Remember, understanding and improving your revenue management can take your practice to huge success.

 

Read more: https://carerevenue.com/blogs/


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