Top 4 Quality Measures To Improve Healthcare Revenue Cycle Management in 2021

In order to maintain the financial stability of your medical practice, it is imperative to sustain the quality of the entire medical billing process to optimize the healthcare revenue cycle management.

Medical practitioners must understand the fact that their long-term survival is not possible without streamlined cash flow. Therefore, they should adopt innovative medical billing solutions to track down the quality measures to improve the overall revenue cycle.

In this challenging era, just like other industries, the healthcare industry is also facing financial challenges in terms of revenue leakage, cash flow disruption, etc.   Moreover, the revenue cycle is dynamically evolving due to the growing challenge of rising costs of medical billing companies and the continuously changing industry.

Therefore, it is crucial for medical practitioners to timely change their strategies. So they keep pace with the healthcare industry and save their practice from critical economic challenges.

If you find it challenging to keep a balance between the billing process and patient care, you should find reliable billing vendors to keep your essential matters (financial, administrative) in-line.

No matters what you choose between in-house or outsourcing revenue cycle management services, you should make sure that the billing process is running smoothly.  You can follow the below-mentioned tips to improve the revenue cycle of your medical practice.

  1. Comprehensive Billing Statements

Medical billers should prepare easy to understand billing statements that are comprehensive to patients as well. Because it is important that patients have an idea about their overdue payments, which ultimately streamlines your revenue collection procedure as well.

On the other hand, if your billing staff uses the complicated language of medical codes, it would become difficult for patients to realize their financial responsibility to pay their dues timely.

Moreover, billing statements, comprising typical coding jargon, obstacle the payment collection and affect the efficiency of healthcare revenue cycle management. Therefore, physicians should prepare measurable metrics in order to determine whether healthcare organizations are proposing a clear and organized payment method for their patients.

2. Accurate coding

Medical coding is an integral part of the revenue cycle. Because codes tell insurance companies about the patient’s diagnosis, medical services, and procedures. Therefore, you should hire certified and well-experienced medical coders to perform this task. Coders should avoid abusive medical practices i.e.overcoding, under coding, etc. Because such coding errors can result in federal penalties, heavy fines, etc.

It’s pertinent to mention here that upcoding occurs when you charge patients more than the payment of actual services rendered. On the other hand, undercoding refers to the concept of charging patients less than the payments of actual services.

The coding errors also lead to claim denials, which hinders the payment collection. So, in order to optimize the healthcare revenue cycle management, you should closely monitor the performance of your coding staff to know the quality of their work.

3. Minimize Billing Errors

Medical billers should make sure that they leave no room for billing mistakes. Because the maximum reimbursements are highly dependent on the timely submission of error-free medical claims.

They should track medical claims throughout the process and make every possible effort to avoid the filing of erroneous claims. For example, they need to double-check the provided data about the patient’s demographic information, submission of duplicated claims, and medical coding.

In order to increase the efficiency of your claims process, you should adopt advanced software to process medical claims. If you are still using the orthodox methods to compile data, processing, and manual submission of paper claims, you should immediately shift your mindset towards the submission of medical claims electronically. Because less human interference reduces the chances of claims denial/rejections.

Moreover, it is also important for healthcare providers to stay updated with the latest, deleted, or modified billing and coding rules. Because it is important to process the medical claims according to current industry standards. Hence, you can optimize the healthcare revenue cycle management with the proper management of medical claims.

4. Follow Up On Unpaid Claims

Medical practitioners lose a significant amount of their net revenue just because of inefficient denial management. So, medical billers must understand the fact that their role doesn’t end with the submission of medical claims.

They should have access to the advanced tracking software to rigorously follow up on medical claims. They need to take immediate action if a claim is denied or rejected. First of all, they should identify the common reasons for claim denials. Then they must rectify and resubmit the claims on a priority basis. Hence effective denial management can maximize the reimbursement in a short time period,

Medcare MSO is a well-reputed medical billing company in the United States. We provide innovative solutions to optimize the healthcare revenue cycle management of your medical practice.

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