Revenue cycle management boosts provider revenue. RCM helps healthcare providers stay open and treat more patients. Revenue cycle management benefits providers and others. Revenue allows providers to spend more time and money on patient care.
By verifying patient information and coding, RCM reduces insurance claim denials and boosts revenue. Providers save time and money by not appealing denied claims. Administrative staff can focus more on patients. The revenue cycle’s many steps are essential for prompt provider reimbursement. Account creation, pre-registration, insurance eligibility verification, and medical coding take longer due to accuracy.
Hospitals, small practices, and larger healthcare systems save lives and treat patients, but they all need financial processes and policies.
Revenue cycle management (RCM) is the financial process facilities use to manage administrative and clinical claims processing, payment, and revenue generation. Patient service revenue is identified, managed, and collected.
Healthcare organizations must survive financially to treat patients. Healthcare revenue cycle management collects profits and covers expenses.
Pathology Revenue Cycle Management Improvements
Your revenue cycle management reflects your business strategy and success potential. Across industries. Business revenue cycles balance income and expenditure. Revenue cycle management in pathology healthcare is much more complicated and widespread than in other industries.
Revenue cycle management within the pathology industry is continuously being enhanced. The revenue cycle is the same for beginner practices and large facilities with multiple patient care departments. Time and workflow efficiency drive everything.
Patients, providers, and insurers control the pathology revenue cycle. Every step of the revenue cycle—from patients calling to inquire about treatment to collecting the balance after insurance reimbursement—is crucial to its success. This is why one should constantly monitor the process for potential issues and update themselves.
Here are some ways practices can improve pathology revenue cycle management:
- Strengthening Data Collection At The Front Desk
Empowering the front desk at your facility to perform billing-related tasks can improve pathology revenue cycle management. By teaching your staff to do the following:
- Accuracy during patient registration:
Whether by phone, online booking platforms, or at your clinic’s front desk, patient information should be complete and error-free. Billing requires correct spelling of the patient’s first and last names, mailing address, and demographics.
- Verify patient insurance eligibility and benefits:
Check its validity, packages since last visit, insurance name, and location. This information lets one check if the plan covers the treatment and inform the patient. If the patient’s policy package doesn’t cover the proposed treatment, staff can suggest other treatments and payment methods. Laboratory Billings requires its clients to verify eligibility upfront.
- Preauthorization of claims:
Clinic front-end staff can start RCM operations by pre-authorize patients to ensure reimbursement before treatment. This guarantees quality care payment. Patient liabilities are also assured. Both benefit. Laboratory Billings also provides an advance beneficiary notice to patients whose insurance does not cover medical expenses.
Automating Manually Performed Tasks
Outsource billing improves pathology revenue cycle management. Clinical data storage and manipulation using an integrated software interface was novel a few years ago. It’s now normal.
Automated appointment scheduling and patient reminders: Automation streamlines your front desk’s patient communication. Patients can book appointments online and enter their information. No longer do patients or staff have to handwrite every piece of information, which is prone to errors. No longer are claims rejected for missing policy numbers or incorrect visit dates. Automated patient reminders ensure patients arrive at the clinic on time, reducing staff workload. This simplifies rescheduling and follow-ups.
- Cloud-based data management system:
The advanced cloud-based documentation system simplifies front-end-to-back-end integration. Each and every detail entered is accountable and easily manipulated to fit revenue cycle documents like billing invoices and claims. This saves time by avoiding data entry for multiple documents.
Billing software automates claim processing. It generates electronic claims from diagnostic and treatment codes. Since insurance companies now accept electronic claims, claim generator software should be customized to meet payer requirements. Laboratory Billings’ practice management solutions use cutting-edge software to automate and simplify the process.
Improved Medical Transcription and Coding Error-free
Detailed electronic health records are essential to verify treatment claims. Transcription should include dates, names, authorizations, and patient visit details. Experts should also code the records, eliciting every codable scenario. Every wrong CPT or ICD code, missing or incomplete data mess up the charge capture process, leaving without payment for the valuable service provided.
- Compliance training:
State and insurance company regulations change frequently, making compliance difficult. Schedule regular coding training as part of your revenue cycle management strategy.
- Coding and billing audit:
Scheduled facility audits improve pathology revenue cycle management. Your staff or outside auditors can do it. Check your billing cycles, payment policies, and billing process for compliance and revenue loss. This helps you spot HIPAA, coding, and fraud before legal issues arise.
Claims and Denial Tracking
All revenue cycle strategies should speed up insurance company reimbursements. Healthcare revenue cycle management requires clean claims. How to make “clean claims”:
- Pre-scrubbing claims:
Send the claim to a clearinghouse or use clean scrubbing software to check for errors and omissions that lead to denial. For inconsistencies, patient, provider, insurance, and coding documentation must be cleaned. It verifies your reimbursement request using health records and helps you submit a complete claim for faster approval, improving pathology revenue cycle management.
- Denial management and appeal process:
Even after perfecting your claims, insurance companies often deny payment. Track your claim request and prepare for appeals and resubmissions. Account receivables improve when denied claims are approved quickly.
RCM Outsourcing Improves pathology Revenue Cycle Management
This improves revenue cycles best. You can focus on patient care by outsourcing administrative tasks to professionals. Pre-authorizations, clinical documentation, coding, bill capture, claim generation, and denial management—practice management outsourcing companies can optimize and streamline your workflow for the best results. Like having a compliance manager in the house to fix data capture issues.
Outsourcing improves your process and helps your staff improve it. Profitability increases with experienced professionals, cutting-edge technology, and other resources. Faster turnaround without compromising HIPAA or privacy.
Laboratory Billings and other RCM outsourcing companies can customize the process for your practice at low cost. Their advanced practice management services can transform your practice. Laboratory Billings’ smart statistical key performance indicator helps you objectively evaluate your practice. Graphs and diagrams help identify workflow gaps. It can help you improve pathology revenue cycle management to increase revenue.
The above methods may improve your facility’s healthcare revenue cycle management. Laboratory Billings can shorten your revenue cycle to boost revenue, personal growth, and business and team clientele. Work with Laboratory Billings to balance running a successful practice with becoming the best in your field.
Related Articles:
How to Overcome Revenue Cycle Management Challenges in 2023
Electronic Health Record (EHR)
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