Image default
Guest Articles

The Increasing Need for Specialized RCM in Healthcare Today

In this article, we have highlighted the importance and increased need for specialized revenue cycle management solutions in today’s healthcare industry.

The U.S. healthcare system is currently transitioning from fee-for-service to value-based care. Still, once that process is complete, it will lose money processing medical bills, managing costs, and collecting revenue. The system’s flaws are especially concerning interactions among payers, providers, and patients. 

Unsurprisingly, COVID-19 has driven important trends in healthcare revenue cycle management (RCM) as both an agent and an accelerant (RCM). Regulations are changing, patient costs are increasing, automation is becoming more important, and significant cultural shifts have forced workers into their homes.

According to CAQH 2016, manual billing systems must improve in the revenue cycle to eat up to 15 cents of every dollar earned. Denials, poor negotiations, and underpayments cause healthcare practices to lose 5–12% of their revenue. Fortunately, increased awareness has led to a growing understanding among healthcare professionals of the benefits of implementing cutting-edge RCM solutions in their operations. To innovate and streamline revenues, they determine the value RCM systems provide. 

Advantages of Revenue Cycle Management (RCM) in Healthcare

It may appear simple, but there are critical steps in revenue cycle management (RCM) that, if not performed correctly, can cause payment delays. Furthermore, coding errors, data duplication, or missing information may result in revenue that your facility relies on to stay afloat. Implementing effective revenue cycle management is a critical component of the success of your healthcare facility. 

Structured revenue cycle management assists healthcare facilities to run smoothly while optimizing cashflows. The following are five advantages of effective revenue cycle management in healthcare. 

  • Improve Workflow to Increase Cash Flow 

When you automate your process, you can increase system efficiency, allowing payments to be made on time while minimizing errors and denials and improving your cash flow. For example, you can simplify your facility’s workflow using an electronic health record (EHR) system. You can improve administrative tasks like scheduling, coding and billing, and payment processing to create a system that is more effective and efficient and frees up your time for more patient-focused activities. This will allow you to focus on what you do best while still achieving your revenue goals. 

  • Streamline Processes to Reduce Workload  

Consistent collections keep your business financially viable and lighten the administrative load on your staff, thanks to a well-run facility. In particular, an electronic workflow can streamline all aspects of the system, including coordinating front and back communication, capping a patient’s journey with on-time payments, and getting rid of lost paper records. Healthcare facilities now have more time to concentrate on offering high-quality care. 

  • Improving Touchpoints to Improve Patient Experience 

The right technology and qualified revenue cycle management specialists will help to ensure a smooth process that minimizes common billing and coding errors. This entails streamlining the procedure and enhancing all patient experience management touchpoints. As a result, your patients experience less unneeded stress, which raises their level of patient satisfaction, which, as you are aware, affects how well a hospital provides care. More importantly, because your staff has more time to spend with the patients, they receive better care. 

  • Better Claim Scrubbing for Fewer Denials 

Payment claim errors cause denials. Optimized revenue cycle management improves the accuracy of your facility’s system, leaving little room for error. You can reduce claim denials and receive reimbursements faster if you get the coding right first. 

  • Improve Revenue with a Faster Collections Process 

When the right software solutions are combined with automation and healthcare analytics tools, all time-consuming tasks, such as data collection, insurance verification, and coding, will take significantly less time than done manually. You can speed up the entire process by automating the cycle’s steps, from eligibility checks and payment follow-ups to data charge entry. Streamlining tasks makes you more efficient and effective because you provide a simpler system to your administrative staff and fellow physicians, resulting in faster collections and improved cash flow. 

Why Do You Need Specialized RCM Solutions? 

Revenue Cycle Management governs all financial operations required to be paid for services rendered. RCM is currently an essential requirement for healthcare practices due to several disparities: 

  • Collection costs must be significantly reduced. 
  • To avoid operational problems, better technology is needed. 
  • High-dollar claims necessitate specialized knowledge. 
  • Underpayments result in significant revenue loss. 
  • Better payment negotiations with payers are necessary. 
  • New practices require a quicker return on investment. 

Every medical service provider’s primary goal is to provide quality medical services to all its patients, resulting in patient satisfaction and reliability. Patient satisfaction is essential for attracting new patients and retaining existing ones. The streamlined processes of RCM solutions increase patients’ dignity and reliance on the medical billing service provider

Any healthcare facility wanting to remain competitive must consult an established RCM provider, and here are a few explanations as to why:  

  • A Distinct Point of View 

A competent RCM consultant will offer your company an unbiased viewpoint. They’ll be able to point out areas that require improvement and assist you in coming up with plans for dealing with them. 

  • Experience And Knowledge 

RCM consultants are highly skilled in resource management and have a lot of management experience. Working primarily with patient data, they can provide insightful advice about how to utilize your resources best. 

  • Individualized Solutions 

A good RCM consultant will collaborate with you to create unique solutions that meet the requirements of your organization. They will consider your business’s size, sector, and objectives. 

  • Enhancing Decision-Making 

By offering analysis and recommendations based on data-driven research, consultants can assist organizations in making better decisions. This can help you save time and money while ensuring you finish the proper research for your company. 

Conclusion 

It can take time to achieve RCM improvements on your own. Staff members who are overworked and undertrained frequently experience lower overall collection rates and declining margins. Every healthcare service provider’s primary goal is to provide high-quality care to all patients, which results in improved patient experience and dependability. Patient satisfaction is essential for attracting new patients and retaining existing ones. The streamlined processes of RCM solutions increase patients’ satisfaction and reliance on the healthcare service provider.

Visit AITechPark for cutting-edge Tech Trends around AI, ML, Cybersecurity, along with AITech News, and timely updates from industry professionals!

Related posts

Why regulating AI is a lost cause

Ala Shaabana

How AI can unlock the true potential of small EMDE traders

Juandre de Jong

The Need for Zero Trust Workload Protection

Satya Gupta