Did you know that the US Department of Labor estimated from the American Association of Retired Persons (AARP) reports that over 200 million medical claims get denied every day? But the most shocking part is that over 60% are simply because of clerical errors among those claims. These denied claims keep piling up, adding to your expenditure and affecting your bottom line. Not all healthcare organizations are equipped with a specialized billing team. Even if they are, the team is often entrusted with performing overlapping administrative functions, often affecting the billing procedure. All these issues can be simplified with the help of a leading RCM company.
Revenue cycle management companies who have been in the medical billing industry for more than a decade have streamlined billing procedures ready for you. They can take care of the end-to-end revenue cycle operations and some specialized functions that need the intervention of an experienced domain professional. If your billing and collection errors are mounting up, and if you are thinking about getting in touch with an RCM company, here are 8 top services that they offer to simplify your system.
1.Updated Coding:
- An RCM Company assigns a dedicated team of medical coders to your case to maintain 100% compliance with the latest coding guidelines.
- If it is a leading RCM company, they come with a lot of experience about the different clinical setups, be it a multispecialty clinic, hospital, or an independent physician’s office.
- The professionals are dedicated to improving your coding accuracy, leading to lower denied claims and improved patient outcomes.
- They also help the organization transition smoothly to the ICD10 guidelines or any other updated guidelines released by the federal and state authorities.
2.Claim Denial Management:
- The claims often get denied due to incorrect insurance information, provider detail errors, or errors in patient demographic entry.
- The RCM Company takes responsibility for refilling the claims by analyzing and rectifying all the errors made before.
- Leading RCM companies use automated tools to run the documents through so that any manual error made can be identified, thus increasing your chances of clean claim submission.
- They also make sure that they analyze the past denied claims to identify a pattern of workflow issues and get back to you with the results.
3.Specialist Billing:
- RCM companies bring years of experience to the table. Also, since they handle a large case volume with several organizations, they have experience billing a range of medical specialties.
- Each medical specialty has a different set of rules according to the federal authorities like The Joint Commission or the CMS.
- Keeping up with the updates can be daunting, and the RCM Company also takes care of that.
- They are also well versed in services like vision billing and dental billing, which need the supervision of domain professionals.
4.Pre-Authorization:
- Obtaining prior authorization for any particular medical service can often delay the urgent assistance of a patient.
- The system of appealing for prior authorization is complex and leads to a back and forth of paper trail between the payer and provider if the documents are not correct.
- The professionals analyze the unique case scenario and support the request with the necessary documents.
- The RCM Company helps you file the proper pre-authorization request in the first time itself, thus decreasing the time gap between the diagnosis and the treatment.
To know how AI can help solve the issues of prior authorization, you can read the article here.
5.Accounts Receivable:
- Accounts receivable form a significant blockage in the path of a medical organization realizing their due revenue.
- However, the evolved kinds of payer plans, where patients are often responsible for a large part of the payment, make AR handling even more complicated.
- The leading RCM companies make it a point to analyze the patient accounts and calculate the risk of payment.
- They also make sure to follow up regularly with the payer networks with the correct references to decrease the number of days spent in AR, thus improving the revenue flow.
6.Charge Entry:
- Charge entry is often the area of revenue cycle management that suffers from a range of clerical errors.
- The professional teams of RCM companies have a required list of points of information on hand when they perform these services.
- They ensure that no small detail is missed ranging from the date of medical procedure to correctly aligned diagnostic codes.
- They have proven models of workflow which make sure that none of the details are missed, and the provider can push for the highest revenue possible.
7.Provider Credentialing:
- The provider credentialing process needs to be completely error-free if you do not want your claims to return unpaid.
- However, administrative teams have to spend a lot of time collecting the vast number of documents and verifying every minute detail.
- The RCM companies can help in making the process simpler since they already have a readily available updated list of documents to check.
- They often accelerate the process with the help of automation software, thus minimizing the errors and improving the quality of the verification process.
8.Customer Support:
- Providing customer support round the clock is one of the key services that any leading RCM company has to offer.
- The billing and support teams work together as an extension of the provider organization itself, improving the process along the way.
- What sets reputed RCM companies apart is their professional,experienced customer support team,who know how to resolve the billing issues within a very short span of time.
- They provide customer support services to both EHR and other medical organizations, adding a holistic dimension to their performance.
We hope this blog gave you a good idea about how a leading RCM company can help simplify your existing medical billing process. For any queries or suggestions, please leave a comment below. For more updates on healthcare and technology, subscribe to our blog. Follow us on Twitter, Instagram, Facebook, and LinkedIn for the latest news.