Altruis shares 5 ways revenue cycle management helps optimize your practice and allows it to run more smoothly and profitably.
Most medical practices aren’t operating optimally. While a practice might be successful at serving patients and fulfilling a need in the community, it can still be struggling to manage its paperwork and make ends meet each month. If this becomes a recurring issue, revenue cycle management services can help.
According to the Harvard Business Review, this occurs for a variety of reasons, including regulatory pressures, financial complexity, scarce resources, the stress of working in the healthcare field, and a long-term lack of business training in medical schools. In short, it’s extremely complicated to run a successful medical practice.
Revenue Cycle Management Advisory Services
When you work with a revenue cycle management service, the first step is usually to conduct a thorough examination of the current business practices and assess what’s going wrong and right. This involves a personalized consultation and financial review.
A skilled revenue cycle advisor looks for opportunities to optimize your processes, procedures, and protocols. They’ll look at practice credentialing, education, training, eligibility, hiring, and much more.
A priority in this process is identifying areas for improvement in terms of managing reimbursement rejections, reconciliations, and other payment issues that impact business stability. Ideally, the advisor works quickly to help minimize your practice’s denials and other issues while maximizing the efficiency of your revenue cycle.
How proactive is your practice about credentialing? Proactive methods support successful reimbursements, prevent denials, and help maintain your valid status with regulatory authorities.
The credentialing process involves careful licensure management to ensure that every provider at your practice is fully credentialed to receive reimbursements.
Programs like Medicare and Medicaid will refuse reimbursements when providers and practitioners are not properly credentialed. This is particularly relevant if your practice intends to maintain its status as a Federally Qualified Health Center (FQHC) with the U.S. Health Resources and Services Administration (HRSA).
Work with your revenue cycle management company to address and resolve any credentialing issues that are negatively impacting your practice. A reputable company should be able to work within established standards like the Coalition for Affordable Quality Healthcare (CAQH) database of uniform credentialing protocols.
Medical Coding Services
Proper medical coding speeds up the business cycle and ensures payments and reimbursements arrive swiftly. This also prevents denials that interfere with your practice’s ability to collect amounts due promptly.
One of the most common problems with medical coding is duplication and repetition of tasks. A provider code is entered in numerous places, creating extra work. There’s also room for keystroke errors that further erode the integrity of the process.
Incorrect coding is also an issue. For example, a newly-hired nurse practitioner or physician’s assistant might be working with the wrong codes and inadvertently creating problems. Your revenue management advisor can look into these issues and get to the bottom of them.
Medical Billing Services
The practice’s medical billing services can now be fully digitized and automated through technology. This brings enormous savings in terms of staffing and costs.
Update your billing services to use the latest medical revenue cycle management technology to facilitate the process. Make sure your billing partner can handle a full array of services including community mental health billing services, ambulatory surgery center billing, and FQHC billing and reimbursement for federally qualified health centers.
Your practice deserves to capture the full value of the revenue you’re owed for your services. The right medical services billing partner ensures this happens on time and to at fullest possible value.
Reimbursements Through RetroPay™
Did you know more than 50% of all U.S. healthcare practices are experiencing an increase in reimbursement denials? Medicare and Medicaid denials in particular are on the rise due to the demands of credentialing and reimbursement in our nation’s complex healthcare system.
Even after an initial denial, the payment can still be recaptured in the future. Or, if the payment was never sought due to a lack of coverage, reimbursement may still be possible.
This is the concept behind RetroPay.TM It’s a revenue management optimization approach that allows a practice to fully capture everything owed on medical services. Old amounts are identified and claimed from coverage, not your patients.
Revenue Cycle Management Builds Success Through Synergy
Revenue cycle management is complex, but it’s well worth the time because it’s the secret to a successful practice. Today, it’s easier and faster than ever with the help of the right revenue cycle optimization partner.
That’s why Altruis is so much more than just a revenue cycle management platform. We’re a trusted partner in the medical reimbursement and management process. Through thriving partnerships, we optimize your approach and empower your organization to pursue success.