Revenue cycle management services

healthcare revenue cycle management services

Healthcare Revenue Cycle Management

Health services play a very dominant and significant role in saving lives and treating patients. While providing quality health care is the goal of any healthcare services, staying financially strong with a healthy Revenue Cycle is the key for them to thrive in practice. Hence it is imperative to have an efficient Healthcare Revenue cycle management process.

Healthcare Revenue Cycle Process

Revenue cycle management in healthcare typically starts with the first step of the patient making an appointment with the hospital and ends when all claims are processed, paid, collected, and settled. This covers the hospital’s entire revenue cycle. The various components in this medical revenue cycle management are:

revenue cycle management process flow chart

Challenges in Medical Revenue Cycle Management in Healthcare

While the healthcare Revenue Cycle Management process appears to be simple and linear, it is interrupted by series of challenges at various stages from scheduling to collection of payments. Claims can often be denied due to various reasons by insurance providers. This could be due to hitches faced at any stage of the process.

While there is a minimum time frame for a claim to be processed, it is also quite normal that some claims are shuttled between providers and payers over several weeks until the differences are resolved. Since most patients may not be in a situation to pay and clear their bills immediately, the revenue cycle management process doesn’t always run as smoothly as expected. In a recent study, 70 percent of providers say that it takes a month or a more to receive the complete payment from patients.

Claims tracking is another tailback to the revenue cycle management process and it must be closely monitored throughout the entire cycle. Issues that are not resolved immediately could result in revenue loss to the providers.

Lack of education and training for the resources could affect the payment collection. Human errors are the weakest link in the revenue cycle management process. Such errors occur majorly while verifying insurance eligibility and coding and failing to collect and key-in all required information into a patient’s record.

The need for a professional Healthcare Revenue Cycle Management Company

With many challenges in the healthcare revenue cycle process, role of healthcare revenue cycle management companies becomes significant. Managing it through medical billing professionals makes the job easier, faster and cost efficient. Revenue cycle management companies take care of the end-to-end process of revenue cycle billing. Hence, healthcare providers can focus on rendering quality service to their patients.

An efficient healthcare revenue cycle management company with its well-designed system ensures the billed amount is paid completely and promptly to the providers. With their expertise and qualified resources, they improve claim approvals, reduce denials, and effectively track claims for prompt payment. 

Why choose Business Integrity Services?

BIS offer an end-to-end integrated revenue cycle management services. With our 100+ years of combined experience, we ensure highest customer satisfaction levels. We leverage our state-of-the-art technology to help accelerate your revenue growth. With our expertise, we manage your hospital revenue cycle at lower cost and reduced turnaround time. We analyse areas of revenue loss, reduce denials, and increase revenue.

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Our key differentiators in Healthcare Revenue Cycle Management services are:

- Optimize time by automating routines like appointment/payment reminder and reaching out to insurers for claim denial.

- Determining a patient’s insurance status and copay requirement.

- Analyzing and providing insights on claim denials.

- Ensuring proper reimbursement for Medicare patients.

- Include error detection to assist in correcting and tracking unpaid claims.

- Review revenue shortfalls.

- Improve TAT of overall revenue cycle billing.

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