Revenue cycle management victory is the heart of any healthcare agency. Defined as the clinical and administrative management of claims management, payment, and revenue production, revenue cycle management is in essence 1 huge financial circulatory system.
Victorious revenue cycle management is really about going back to the basics, particularly when it comes to making sure the accurate, timely, and compliant claims reimbursement.
“Agencies that do not involve in thoughtful preliminary planning regarding revenue cycle operating standards … can find themselves with a mixed bag of gained practices that are both difficult to handle and unprofitable,” stated Benjamin C. Colton and David A. Wofford of ECG Management Consultants.
Here is an exploration of top issues and opportunities that arise throughout numerous stages of a medical claim’s life cycle.
Many challenges exist within the verification stage
When a sufferer first contacts a physician office or healthcare contributor to make an appointment, the claims reimbursement procedure begins.
This is the stage when patient data – involving insurance information, provider eligibility, and diagnosis codes – is collected and stored.
But collecting precise and timely information is not always easy. A beneficiary’s claim becomes eligible for payment merely after the unfolding of a fairly convoluted process.
For 1 thing, revenue cycle management systems perhaps demand a bit of restructuring.
A more streamlined approach where patient accounting, billing information, and electronic health records (EHRs) are closely integrated and more tightly aligned may assist.
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