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Revenue Cycle Management

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Revenue Cycle Management

As medical administrators, you have a lot on your plate. Your ultimate goal is to provide the best care and services to your patients, but there are many different processes involved in that goal. From a patient’s perspective, their visit begins when they walk in the door and ends when they leave, or when they pay their final bill. However, you know that the life cycle of a single patient visit actually begins when they make their appointment, and may not end for weeks or months afterward. This is your revenue cycle, or the process of managing patient accounts and receivables. One of the best ways to ensure that your patients are well cared for before and after their visit is to make your revenue cycle management, or RCM, as efficient as possible.

Challenges of Revenue Cycle Management

From the moment the patient books their appointment, you begin the RCM process. Even when everything runs smoothly, the life cycle of one patient visit can last weeks or months. Your staff verifies insurance, documents and codes treatments, bills the patient for their co-pay, files insurance claims, waits for reimbursement, and deals with denials. Often, these are the same folks responsible for dealing with patients directly, from intake to customer service. The more responsibilities your staff takes on, the higher the likelihood of errors. 

The number one reason for insurance claim denials is inaccuracy and errors on paperwork. Simple things like an incorrect ICD-10 code or a missing signature can result in a denied claim. In this case, you have to file an appeal, which delays reimbursement. This can also result in an incorrect bill to the patient. No one likes to receive a bill they don’t rightly owe, so this can frustrate patients and discourage them from wanting to return to your practice, refer other patients, and leave positive reviews.

Additionally, placing too much responsibility for extraneous tasks on staff leads to burnout and dissatisfaction. Great employees are difficult to find, and every effort should be made to hang onto them when you find them. While health care will always be a demanding field, there should be limits to how much one person is expected to handle. When good employees are overworked and stressed, they make mistakes. Not only do those mistakes cost you in lost claims and revenue, they also cost you money when you lose the employee. You’ll spend a great deal of effort finding and training a replacement. One of the best ways to avoid these pitfalls is to outsource parts of your revenue cycle management. 

RCM Solutions

Consulting a specialist is always recommended for diagnosing and treating complicated ailments. Similarly, an organization that offers specialized RCM services may be better equipped to efficiently handle administrative tasks related to medical billing and claims.

After the rising cost of supplies, rejection or delays in reimbursement is the biggest challenge faced by healthcare institutions today. Administrative errors can result in submission of inaccurate information in claims and can slow down or stop collection of payments.  In many cases, rejected claims end up as bad debt when simply resubmitting the claims with accurate information may suffice. Outsourcing RCM can help hospitals and practices avoid seemingly minor administrative mistakes that can slow down insurance reimbursement and payments. An expert agency that specializes in collection management helps hospitals and doctors’ offices to streamline the revenue cycle and minimize errors and mistakes.

Efficiency is the key to maximizing revenue and boosting profits. A recent Black Book RCM vendor client experience poll found that more than 70% of hospital CFOs found RCM outsourcing to be the best model for efficient revenue management. Their experience is supported by the fact that of larger group medical practices. Research shows that close  to 70% of physician groups with more than ten professionals preferred to outsource tasks related to the processing of claims and management of collections.

Southwest Recovery Provides Revenue Cycle Management Services

When you decide to outsource your RCM, you need a partner you can trust. Southwest Recovery Services has been in the business of collecting debts for over 15 years. Our management team has a combined 70 years experience in the third party collection industry. We know that RCM is not typical debt collection. We have focused, dedicated agents responsible for the unique needs of our medical RCM clients. They are well versed in the intricacies of medical transcription, billing, insurance, and when necessary, collections. Our collection services function as an extension of your practice by providing accurate and updated information about charge capture, submission of claims, processing and remittances and other related administrative tasks. Our caring and friendly approach to debt collection is especially well suited to medical bill collection, and you can be assured that our reputation is safe with us. 

Streamline Your RCM with Southwest Recovery Services

We have the utmost respect for our health care providers, especially in uncertain times. Now more than ever, it’s so important for medical staff to be focused on patient care. Leave the rest to a trusted partner. Give us a call or contact us to learn more about how we can help you.


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