Are you worried about your revenue management cycle? Are you confused about how to improve it? These questions arise due to improper practice revenue. As a healthcare organisation, you shall be able to monitor your revenue cycle. Overlooking certain aspects could result in more significant setbacks.
Seeing this as a topic of concern, the Medical Group Management Association (MGMA) says that healthcare centres can save $16.3 billion or 42% of the $39 billion on administrative transactions with proper revenue cycle management. But, first, you need to understand the essential factors to achieve the mentioned results.
Following are the major factors that will help you optimise your practice revenue:
1. Verification of Patient’s Eligibility
Patient eligibility is the prime factor that you need to keep in mind during practice revenue. Being in this field, you collect your payments from the various payers. Hence it is extremely necessary that you verify the patient’s eligibility for the particular service. Special monitoring is required, especially when it is the case of cost-sharing and high-deductibility insurance plans.
Pre-verification of patient eligibility will save you later troubles such as claim denials and help you recover your payments faster.
2. Billing according to RAMQ Standards
The problem with interpreting billing rules is that it varies from professional to professional. In such scenarios, if you underbill, it will bring a negative impact to your revenue cycle, and if you overbill, you will come under the suspicion of RAMQ.
Hence it is a major necessity to have a medical billing professional who knows the RAMQ standards and adheres to them.
3. Credentialing, Enrollment and Claim Denials
In the process of practice revenue, the importance of credentialing and enrollment of new providers is to avoid payment failures, delays and claim denial. Conducting these processes on time at regular intervals will prove highly beneficial to your organisation.
4. Knowing your Agreement
You need to thoroughly read your agreement and understand the specific details. The mentioned details will give you the required information about updated rules and regulations that needs to be followed according to the contract.
If these all are ignored, then it will cause you financial loss, fines and increase your liability.
5. Using Right Software
Currently, you will find numerous software to help you with Medical billing. But you need to know the right one to optimise your billing process. Using the proper software will assist you in managing your data properly. If this is ignored, then it will prove to be a disadvantage to your system, increasing your workload.
6. Tracking the Financial Performance
Regular analysis of KPIs is a must. You also have to monitor your system continuously for any financial leaks. This will boost the performance of your revenue cycle and help you know the points where you can improve.
The best way to attain such goals faster is by outsourcing your medical coding and billing procedure to a trusted agency.
Keeping all the above focus points in mind, you can improve the practice revenue that will show you tremendous results in your revenue cycle.