Your medical practice revenue is driven, impacted, and influenced by Revenue Cycle Management (RCM) strategies. It includes claims management, patient payments, and your in-house billing workflow. Without implementing these strategies, providers might find it difficult to maintain high levels of clean claims, adjust to an increasing dependence on patient payments, or manage their billing effectively. Doing so may not only help sustain your medical practice revenue but will provide a steady flow of revenue. For this reason, providers need to consider the following options at tactics to improve practice revenue by implementing these RCM strategies.
RCM Strategies to Improve Practice Revenue
Collect Difficult Patient Payments
With more and more patients opting for High Deductible Health Plans (HDHP), patient responsibility is increasing rapidly. Collecting these patient payments could be a challenge for providers, especially small practice owners with fewer resources. The best way to collect patient payments is at the time of service, if you fail to collect at that time, the chances of recovering those payments decreases after every week while the cost of recovering that amount increases rapidly. The best way to collect such difficult patient payments is to have eligibility and benefits verification for every patient. You should have an insurance coverage report for every patient and need to update it prior to every visit. With eligibility and benefits report you know insurance coverage for planned services, co-payment amount, and unpaid deductibles. You can communicate with patients, prior to their visit, about out-of-pocket expenses and available payment options like online payment or credit card payments. With this strategy, you will require fewer resources and can collect more patient payments quickly.
Improve Clean Claims
A clean claim is a correctly filled claim without any wrong or missing patient and insurance information. Ideally, your clean claim percentage must be more than 95 percent. Submitting a maximum number of clean claims will ensure that insurance carriers can process in the first attempt ensuring quick payments. Your claim may get rejected due to incorrect insurance information, patient demographics, wrong DOS, non-payable diagnosis codes, incorrect NPI, wrong billing information, and many more. To increase your clean claim percentage, you have to streamline your front desk activities. This will include taking insurance and patient details prior to the appointment and cross-checking this information. You can create an account in the provider portal for every payer and can cross-check insurance information and patient demographics to ensure the highest clean claim submission. Some billing software or clearing house software provides you with this information with a single click. When you are filling these details in billing software, the system will cross-check the details and notify you in case of any errors. If you streamline all billing activities prior to claim submission, you can easily achieve more than 95 percent clean claim percentage.
Specialty-Tailored Billing Software
Choosing specialty tailored billing software increases your practice revenue and can help to grow the bottom line. Many popular billing software offers a ‘fit-to-all’ solution that fails to meet the requirement of specialty-wise medical billing. By implementing specialty-specific software, providers can access tailored billing tools like a specific list of coding and claim filing tools that help your practice optimize its medical practice revenue and bypass unnecessary information. Such billing software can notify in case of non-billable diagnosis codes, a common resolution to a denied claim.
Patient Scheduling
Improved patient scheduling is an incredibly important part of increasing your medical practice revenue. Patient no-shows negatively affect the bottom line of any practice. Whether patients are forgetting, scheduling workflow is not working, or there are low levels of patient loyalty, improving scheduling is necessary to move forward. By reducing no-shows, providers bill more for completed services, complete more follow-up care with their patients, and are not wasting their time when their patients do not show up. Improved scheduling can be accomplished through a quality integrated practice management software and patient portal. With the right software, providers can improve their scheduling numbers and positively impact their medical practice revenue.
Improving practice revenue by using RCM strategies is a team effort, only providers’ efforts are not sufficient. You should be equally supported by your front desk team, billing staff, and medical coders. If you feel like you are not employing experts from these areas then think about outsourcing to MEDIMAXSOL. With all responsibilities like insurance coverage reports, prior authorizations, charge entry, payment posting, denial analysis, rejections, and accounts receivable management completely handled by us, you can just focus on your patients. To know more about how we can assist you in RCM strategies and ultimately help in improving practice revenue, contact us at info@medimaxsol.com / (305) 709-0282