Revenue Cycle Management System

Advantage of Outsourcing RCM:

The advantage of Outsourcing RCM is avoiding the high cost of staff turnover. The revenue outlook for medical practices and healthcare organizations is concerning.

Turnover Rate among Healthcare Revenue Management Companies:

Employees in the Healthcare Revenue Cycle Management Companies represent nearly 30 percent of the 19 million people who quit their jobs during those five months. Only three industries accounted for a greater fraction of food services, professional business services, and retail trade.

Furthermore, the unemployment rate in the Healthcare and Social Assistance sector was 3.9 percent in August 2021, compared to the overall unemployment rate of 5.2 percent. The gap was even wider in the Hospital subsector, where unemployment was only 2.7 percent.

Resignation’s Impact on Overall Employment:

Help wanted signs to exist, and job boards update with new openings every hour. Is it any surprise that employees are quitting their current positions in droves? It’s easier than ever for employees to give notice, whether it’s for more money, better hours, or more perks. According to the Bureau of Labor Statistics, 19 million people did just that between March and July 2021. Each of those months saw an average of nearly four million employees quit their employment.

RCM Helps Your Profitability and Patient Experience:

Providers may be attracted by the promise of decreased operational expenses to integrate the latest AI technology, and there are plenty of possibilities. However, while selecting and deploying automation, it’s critical to be highly deliberate. Automation isn’t only about lowering labor expenses; it’s also about freeing employees to focus on more important patient-centric tasks. It can save operating costs while simultaneously improving the patient financial experience and staff morale when used wisely.

Working of RCM in Healthcare:

Simply put, providers must collect payments for services rendered to generate revenue for their organization. However, the process is not always as straightforward as it appears.

Consider healthcare revenue cycle management to be a journey. It begins when a patient schedules an appointment and ends when all patient payments for medical service(s) received have been collected. As we progress through the journey, providers face numerous challenges, beginning with the front-end intake process and going through back-office operations to ensure that payment is ultimately secured.

Revenue Cycle Management System Benefits:

An optimized revenue cycle will reduce denials. Fewer claims will be denied as errors and redundancies are addressed and prevented on the front end.

One of the most obvious advantages of a healthy revenue cycle is increased collections and revenue and faster collection processes, particularly when the process is automated. The entire collection process can be accelerated, reducing administrative burden while increasing accuracy.

Challenges in Revenue Cycle Management System:

Navigating healthcare claims is difficult and expensive. Providers and facilities are frequently caught in a cycle of inaccurate claim submissions, denials, corrections, and rebilling, which delays reimbursement and negatively impacts financial performance.

Medical Billing Companies face many challenges during Revenue Cycle Management Process. Following claim submission, provider personnel will monitor and track claim status. Surprisingly, many businesses still rely on a manual process for this and for managing any claims that are ultimately denied. This is a drain on productivity, time, and resources, making it more difficult for providers to respond to denied, pending, or returned claims for reimbursement on time.

More Patients are unable to pay their medical bills. Some are presenting as self-pay (possibly more than ever during the pandemic). Some may be unaware of subsequent coverage or that they are eligible for charity assistance. All of which have a direct impact on providers’ ability to collect. A lack of transparency in service pricing can make it even more difficult for patients to budget.