7 Steps To A Complete Revenue Cycle Management

Is the team in your medical practice doing an impeccable job? That’s great. However, you have to pay close attention to the financials as well. Staying on top of your revenue cycle management process will help your practice to thrive. Therefore, it’s very important to understand the following 7 steps to a complete revenue cycle management. Having a clear process in place will ensure efficient management of the business in your practice. Let’s go through the steps.

Step 1: Outsourcing to professional billers
Having an in-house billing team is enticing but costly in the long run. It comes with investing in equipment and more office space for the billers. Additionally, you will have to budget for staff salaries and benefits. The most cost-effective idea is to outsource the billing process to professionals. These have a professional team and appropriate resources to perform a wonderful job, so whether you need managed care contracting solutions or simple help with billing, outsourcing will give your staff the chance to focus on offering quality patient care.

Step 2: Patient pre-authorization
This is an essential step in the medical billing process. The process requires getting an agreement from the insurance company to cover particular services before it’s offered. Pre-authorization is only exempted during emergencies. However, ensure to keep in mind that pre-authorization for a service is not a guarantee that the insurer will cover the cost. Therefore, it’s important for the patient and provider to cross check to eliminate doubts about coverage.

Step 3: Verification of eligibility and benefits
When booking patients, it’s very important to verify their eligibility and expected benefits. Having your employees do it over the phone is a bit time consuming and likely to demoralize employees. Luckily, outsourcing the billing process to one of the medical billing companies in Houston will handle this seamlessly. These have the right means to check patient eligibility to speed up the billing process and verifying patients’ entitled benefits.

Step 4: Submission of claims
Receiving payment from insurers is only after proper submission of claims for the services rendered. Your team of professional billers will submit all claims after scrutiny to ensure that they are free from errors. This will lessen the chances of claims rejection and denials. Professional billers can detect any mistakes in the process and fix them before submission. Gaining tighter control over claims will ensure accelerated revenue inflow.

Step 5: Posting of payments
With the successful submission of claims, the payers will review and post payment. Your professional billers should have the ability to generate billing statements. Additionally, the billers can have a system in place to send reminders to payers to reimburse promptly. This will ensure speedy reimbursement of payments into your practice.

Step 6: Denial management
This step requires having a system in place to handle denied claims. The billers should investigate the cause of denials to find appropriate solutions. Fixing problematic claims will ensure higher earnings into your medical practice. Having a denial management strategy will help to recover revenue that might have been lost because of errors that could be fixed.

Step 7: Billing reports
To get a clear picture of your financial situation, it’s very important to get detailed reports from your billers. These might help you get a clear picture of the financial situation in your practice. Your billers should offer timely reports including management information, financial data, and key performance indicators. Professional billers have systems in place to generate reports without slowing down other aspects of the billing process.

The nature of your revenue cycle management process can break or make management of your practice. An efficient process in the hands of professional billers will ensure timely submission of claims leading to regular cash inflow for smooth operations.
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