6 Ways Revenue Cycle Management (RCM) System Reduces Errors & Increases Revenue

With changed industry norms and requirements of services in the healthcare industry, the existing computation infrastructure of medical billing companies requires to witness transformations in order to get tighter control over the flow of revenue.

With a more systematic analysis of the internal components of medical billing, revenue cycle management seeks to highlight relationships that can be improved or expanded to increase the revenue base. 

For healthcare providers, this can take the form of tactical attempts that increase patient satisfaction to reduce the risk of medical malpractice lawsuits or to be denied charges by insurance companies and to increase the likelihood of repeated business.

RCM practices and service solutions can streamline a vast array of most intensive processes (coding, balancing budgets, filing claims, appeals, payment posting, and many more) providing a supreme level of operational control that helps to avoid loss of revenue, profitability, and productivity.

Let’s take a rundown and see how RCM can help reap revenue benefits, reducing the probabilities of potential billing errors. 

Top Ways RCM System helps to Reduce Billing Errors & Boost Revenue

#Submit Claims At the Highest Value

Submitting inaccurate claims often leads to receiving their status as Rejected or Denied. Potential billing problems and returned claims account to the following primary reasons:

  • Incorrect provider information (address, name, contact information, etc.)
  • Erroneous patient information (gender, name, DOB, insurance ID number, etc.)
  • Mismatched/inaccurate medical codes (entering confusing ICD codes with CPT codes, or vice versa, etc.)
  • Wrong insurance provider details (incorrect policy number, address, etc.)
  • Duplicate billing

In order to ensure that the claims are submitted at their highest possible value, it’s more efficient to process patient data through an automated system (RCM software tools) rather than refining and sorting sensitive information manually.

“RCM brings potential reductions in Reimbursements.”

RCM processing is easy to rely on as it keeps track of the claim values (ensuring appropriate logged data, generating error-free medical codes, etc.) that keep negligible chances of getting slipped through cracks.

This helps you to get properly reimbursed, thus optimizing your medical billing and financial services.   

[Prefer Reading: “How to Optimize Cash Flow with RCM Best Practices?”]

#Coding Flags

With all the new requirements propagated via the revised ICD-10 list, the healthcare provider industry has witnessed burgeoning oversight capabilities among professionals. This resultantly led to over-increasing billing errors and coding issues that form the basic cause for denied claims and revenue loss.

This calls for the need for an effective RCM system to be applied in place that helps vet billing codes and flags the identifiable errors beforehand. Automated systems are capable of flagging the common mistakes that occur at general places.

These flagged errors can be easily identified by administrators handling the coding and claims and can be resolved before they get filed and processed further, thus, saving time and eliminating the possibilities of rejections/appeals.

#Claim Tracking and Collection

Working with strenuous care and attention may even let employees make a typo error or choose incorrect code for billing. These small slips may cause big troubles that no healthcare organization can afford to accommodate.

One of the best Revenue Cycle Management features is the ability to track claims and check their status in real-time (supported by technology), detect potential problems, quickly edit them, and resubmit them to achieve positive claim results. 

This enables a business to drive better ROI results and impede the generation of revenue and enhancement of productivity.

#Identifying Missing Codes/Charges

The urgent demand for patient care has led to the laddering heaps of patient files that need to be processed with acute care and attention in order to process quick collections with any delays.

The increasing demand caused a burden on service providers where manual patient file handling poses risks to emerging missing codes and charges. This becomes the prime reason for instant denials, wasted hours and resources, and loss of actual dollars to be received by the healthcare service providers.

These financial consequences can be alleviated by implementing a robust Revenue Cycle Management software in place that determines missing charge entries and automatically assembles bills and invoices, corresponding to the patient file records.

An ideal medical billing system ensures not to accommodate any missing codes, charges, entries, or any other incomplete patient detail that become the cause of disruption in your services and practice’s cash flow.

[Prefer Reading: “Benefits of Outsourcing Revenue Cycle Management (RCM)”]

#Flagging Underpayments

Humans are prone to more inaccuracies and calculated errors, patients and payers can make mistakes too where an invoice may turn up with partial payments. Such flaws and faults are not recognized by every back-office employee due to incorrectly logged patient data.

“RCM allows faster processing of account receivables, clearing pending balances, and accelerating revenue collections.”

Organizations bolstered by powerful and result-oriented RCM and medical billing systems are able to log appropriate medical data of patients like entry, insurance details, demographics, denials status, ARs, etc., and get the missing funds back into the billing cycle to render accurate and expected results.

RCM lowers the possibilities of underpayments, provides auditing, and ensures consistency in payments and collections while eliminating dependencies over specific tasks and teams.

#Streamline Workflow & Revenue Laxities

Paper-based work and processing aren’t considered adequate and acute as they get exposed to lapses that go untouched or unprocessed once they get submitted.  

On the other hand, digital medical billing software systems digitize the traditional error-prone procedures and streamline each step of the workflow, delivering accurate and error-proof results.

“RCM processes also allow for instant views of your financials.”

From admitting and provision of care to billing and accounts receivable, every single patient file and service data is logged, updated, monitored, tracked, and pushed further to the proceeding stage via the power of automation, aiding administrative personnel by making complex tasks simpler and smooth.

Unprocessed files, data lags, denials, expiries all can be flagged and processed, without any miss or slip of crucial data and gets you synthesized and harmonized practice’s data in hand.   

[Prefer Reading: 5 Ways to Improve Claim Denial Rates For Your Healthcare Center”]

Get Effective RCM Services at the Heart of your Medical Practice!

There is a lot of information to absorb when it comes to Revenue Cycle Management and Medical Billing, and strenuous efforts to make, to get your healthcare establishment to function efficiently and promptly, amplifying revenue results.

Experts at NetSet Digital are highly certified and trained to assess your organization’s business needs and overcome challenges by rendering customized medical billing solutions that aim to put money back into your pocket, improving your collections and cash flow.

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