https://www.lezdotechmed.com/services/revenue-cycle-management/
Why RCM?
Revenue cycle management is a vital service in medical billing. Medical Billing services are being utilized by various providers including Urgent Care, Family Medicine, Internal Medicine, Pediatric & Mental Health to speed up the collections & cut down their cost down by 50%.
Steps in Revenue Cycle Management
1. Credentialing
Payer enrolment for allowing you to network with various organizations.
2. Eligibility and Benefit Verification
Checking the effective date of the patient’s policy and identifying the covered and non-covered services.
3. Transcription
Converting the recorded audio files to Text /Medical records.
4. Coding
Converting the medical diagnosis and procedures in medical records to Alphanumeric codes.
5. Demographic and Charge Entry
Entering the patient’s details and alphanumeric codes into the billing software.
6. Claims submission – Paper or Electronic
Submitting the claims or bills to the insurance company.
7. Payment Posting
Payments are entered into the respective patient’s ledger.
8. Denial Management
Corrective actions will be taken on unpaid/denied claims.
9. Account Receivable Follow up
Addressing the no response claims.
10. Patient statement
All the patient responsibilities would be notified to the patient in the form of statement/Bill.
Revenue Cycle Management Services
Eligibility and Benefit verification
Eligibility verification involves checking the effective date of the patient’s policy and making sure whether the patient’s policy is active for the given date of service. This could be done via website and reaching out the insurance representatives via phone.
Benefit verification involves checking whether the service is going to be rendered are covered under the patient’s plan and to determine the patient responsibility.
Medical Coding
Professional Medical coders help you to ensure the ICD-10 / CPT codes are applied correctly during the medical billing process, which includes abstracting the information from medical record documentation, assigning the appropriate diagnoses and procedure codes, and creating a claim to be paid by insurance carriers.
Account Receivable Follow up
Medical billing professionals would find out the claims for which we did not get a response from insurance even after 30 days from the submission. Follow ups via phone call or website would be made. Highly precise process ensures a recovery of unpaid claims.
Demographic and Charge Entry
Incorrect Demographic information is one of the reasons for medical claims being rejected. The correct and quality entry of Demographic information and charges positively impacts the quick settlement of the claims. Error-free patient demographic entry and charge entry is the first step in the process of submitting a clean claim.
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The Healthcare RCM Process is a complicated cycle, it follows an order and it flows in the way as mentioned below: RegistrationFinancial CounselingCharge CaptureUtilization ReviewMedical Record DocumentationClaims SubmissionThird Party Follow-upRejection ProcessingPayment PostingAppealsContract Management These are the processes included as a part of Healthcare Revenue Cycle Management Services.
They differ in their features based on the type of software that the Hospital or Clinic is using.
These are the organizations that not only provide Healthcare Revenue Cycle Software but also Healthcare RCM Solutions.
From providing Healthcare Revenue Cycle Analytics that include customized reporting of financial data, information management and providing key performance metrics, it is also ensured that intuitive data visualizations are present to get a better understanding of the reports by just rolling one’s eyes through the charts and graphs -- all just in a single glance.
Errors such as code flaws, inaccurate capturing of patient data, low quality of patient engagement and other factors are analysed using Healthcare Revenue Cycle Analysis softwares in order to get an overview of the situation and ensure that Healthcare Revenue Cycle Management Optimization is done correctly to leave no room for errors.
Also, in hindsight, Healthcare Revenue Cycle Management (RCM) Outsourcing does not account to being a better fit than Healthcare RCM Softwares.
The Research Report on Back-end Revenue Cycle Management Market Consist of 79 market data Tables and 31 Figures spread through 136 Pages and in-depth TOC, which covers Global Market overview, Major Key Players detailed Analysis, market opportunities, market risk, forecast for the next five years, major driving factors for the market as well as detailed analysis for CAGR, scope, research findings, leading key players marketing strategy to acquire major market in the form of revenue.The Back-end Revenue Cycle Management Market is projected to reach USD 10.4 billion by 2023 from USD 8.1 billion in 2018, at a CAGR of 5.0%.
Back-end Revenue Cycle Management Market Based on product & service: Based on product & service, the market is segmented into software and services.
The services segment is estimated to witness the highest CAGR during 2018–2023.
The high growth of this segment is primarily due to the recurring nature of services such as training and development, installation, software upgrades, consulting, and maintenance.Back-end Revenue Cycle Management Market Based on software type; By software, the market is broadly segmented into integrated and standalone software.
In 2018, the integrated software segment is expected to account for the largest share of the back-end RCM Market.
The large share of this segment can be attributed to the ability of integrated solutions to help users to streamline and coordinate multiple financial functions through a single platform.Download PDF (Back-end RCM Market): https://www.marketsandmarkets.com/pdfdownloadNew.asp?id=204439794 Back-end Revenue Cycle Management Market Based on end user;By end user, the market is segmented into healthcare payers and healthcare providers.
MD billing solutions furnish us with the best service of RCM (revenue cycle management) with full guidance with no hidden fees
Learn how to address Revenue Cycle Management healthcare challenges with tips from Business Integrity Services.
