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Implementing Software Based Process to Reduce Denials in Medical Billing

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Unify Medi Craft

Revenue cycle management is a crucial part of any healthcare organization. However, some facilities struggle to maintain good revenue cycle management because of the complexities of the billing process.


The consecutive financial consequences can hurt the backbone of the healthcare organization’s bottom line. One of the best ways to minimize RCM-related woes is to create or invest in RCM software.


However, to make the most out of it, healthcare organizations need to understand how RCM technology works, the benefits of RCM software, and know all the available RCM software vendors.



What is RCM Software?


An RCM software is a suite of tools and applications designed to streamline the RCM process and reduce manual efforts like data entry.

RCM software helps healthcare organizations automate RCM tasks like patient registration, insurance verification, claim processing, payment posting, and denial management.


RCM software is a useful practice for complex billing and coding procedures. These services need to be coded accurately to receive reimbursement.


According to ReportLinker's 2023 RCM Software Global Market Report the RCM software industry was worth $41.72 billion in 2021 and will supposedly reach $69.16 billion in 2026.


Importance of Healthcare Management Software in 2024


Technology is playing a massive role in our day-to-day functions. The same has happened with the healthcare industry.

There are numerous healthcare management software's available in the market that provide better patient care with RCM software top among them.

The right RCM solution will help you address several healthcare challenges.

·       Labor Shortage

The healthcare industry is going through a labor crisis. There are more than 2 million unfilled posts which hampers the workflow of all departments, especially the financial department that takes the biggest hit.  


Various finance leaders in healthcare organizations say that they need at least 20 more employees to meet the staffing needs of their RCM departments.


An effective billing software can help your organization cut down on manual data entry and loads of paperwork. It reduces the need for extra staff and the risk of errors due to manual entries.


With the software’s analytics capabilities, healthcare facilities can identify process inefficiencies and make continuous improvements.

This process helps to get the most out of the current staff while meeting the RCM needs.


·  Denial Rates


One of the major setbacks for any healthcare provider or organization is denied claims. Between 2016 and the end of 2020, denial rates spiked by 23% even though 86% of denials can be avoided with accurate medical coding.


This results in huge losses of revenues for healthcare organizations which leads to decreased satisfaction for patients.


One of the best ways to counter this problem is by implementing RCM software. By streamlining the revenue cycle process and automating many tedious tasks associated with billing and reimbursement, you can reduce loads of errors and denials.


Effective healthcare management software speeds up the entire process.


RCM software also provides valuable insights into potential improvement areas which further reduces denials.


When automatic eligibility checks are implemented, RCM software ensures that providers only submit claims for patients eligible for reimbursement. This reduces the number of denials that happen due to no coverage.


·  New Price Transparency Regulation


As the healthcare industry grows and evolves, new regulations are implemented to ensure patients have access to accurate and transparent information about their care.


The passing of the No Surprise Act in 2020 brought a new host of regulations for healthcare providers.


One such regulation concerns price transparency, which requires every practitioner to provide “good faith estimates” to self-paying and uninsured patients.


This means that before providing any medical services, practitioners must provide an estimate of the cost of those services.


Additionally, RCM software helps patients ensure that providers do not overcharge patients and make costly mistakes that could lead to heavy penalties.  


· Impact of Inflation

Inflation is one of the most significant challenges for the healthcare industry.


The average cost of healthcare services in U.S has increased faster than the rate of inflation. It burdens the providers as well as patients in the same way.


Healthcare providers need to be creative to tackle this situation. RCM software provides analytics-driven solutions that allow health facilities to understand and calculate their financial situation.


With this information, providers can make informed decisions about how they can manage finances to reduce the impact of inflation.


Benefits of RCM Software


Using revenue cycle software helps organizations streamline and manage revenue cycle management efficiently.


Manual processes can be very time-consuming. With automation, a lot of human effort and time is saved that can be devoted to patient care.


It helps in the collection of ARs and makes the reimbursement process faster. It will help you reduce the risk of bad debt by offering features such as predictive analytics and patient estimate tools that let patients know how much they need to pay.


It also improves the patient experience which converts them into loyal customers.


Once you have implemented RCM software in your workflow, you do not need to train the staff about the guidelines, or the security practices used in your organization. All the work will be done with the software.


When all the data is stored in a single place, drawing analytics and getting insights become easier.


These are just some of the benefits that will surely improve and enhance your revenue cycle management. Once you start using RCM software for your billing procedures, you will experience a huge increase in reimbursement as well as patient satisfaction.


The Best Medical Billing Software


As the popularity of RCM software is growing, there are numerous vendors who offer software solutions for healthcare organizations.

But if you want the best software that takes care of all your medical billing and coding simultaneously, you should go with Unify Medicraft. Unify Medicraft is the best RCM software which is used by various healthcare organizations as well as individual practitioners. They have all seen a massive increase in their revenue as well as patient satisfaction.


Good RCM software will take care of all the guidelines and compliances you need to follow to continue your practice. It will also bring an end to your hassle of paperwork and reduce your workload so you can focus less on your revenue management and more on patient care.

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