A healthy business can improve outcomes, patient satisfaction, and patient care. Optimize patient care by streamlining revenue-related processes.
Implementing new processes requires a practice management system (PMS) revenue cycle management solutions that work for your staff. You can use electronic processes with your PMS. Gather input from your staff, make a priority checklist before choosing a new PMS, and ensure it works with your EHR.
6 Tips for Physicians on Revenue Cycle Management
Use these six tips to streamline your revenue cycle management processes once you've installed a PMS that works for your practice:
1. Check insurance eligibility before visiting
Patients can verify their eligibility over the phone or on the Web, but these methods are inefficient and may not provide all the information needed. Time can be saved by electronic eligibility verification. A patient's insurance information is collected and submitted electronically to the PMS when an appointment is scheduled. Responding within 20 seconds is required by federal regulations. Upon check-in, patients can be informed of any financial obligations.
Checking insurance eligibility is a fundamental part of revenue cycle management for physicians. It helps ensure that the physician will get paid for their services and protects against bad debt. Checking eligibility also allows the physician to give the patient an estimate of their out-of-pocket costs. By checking insurance eligibility, physicians can improve their bottom line while providing a better experience for their patients.
2. Electronic transactions reduce prior authorization burdens
Physicians can complete prior authorization requirements electronically as part of the e-prescribing process. Vendors for e-prescribing systems are implementing the technology for these transactions at various stages, so ask your vendor when this technology will be available. There are many reasons why physicians should reduce electronic transactions prior to authorization burdens.
The three main points are: it would help to improve patient care and communication, reduce the amount of time spent on particular administrative tasks, and increase efficiency and job satisfaction among physicians. Physicians can also play a role in policy change related to this issue. We hope that by sharing this information, we can empower more physicians to take a stand against onerous EHR-related burdens.
3. Streamline claims with electronic submission
By submitting health care claims electronically, time is saved, and payment is accelerated. Your practice may submit an electronic claim electronically or indirectly through a clearinghouse or billing service that pre-audits or "scrubs" claims before submission to look for errors. It reduces payment delays and denials by addressing potential issues before the claim reaches the health plan's adjudication system.
By streamlining the claims process with electronic submission, physicians can avoid penalties, get paid more quickly, and focus on their patients.
Claims software makes it easy to submit accurate claims the first time around, so there's no need to waste time or money on resubmitting denied claims. And when you get paid faster, you can reinvest that money back into your business or patient care. If you're not currently using electronic claim submission, now is the time to start Streamline your claims process today.
4. Check a claim's status
Claim status is often unknown until the health plan pays, pended, or rejects it. Confirm receipt and determine the status of submitted claims using an electronic claim status inquiry. You can check the status of multiple claims simultaneously by sending "batch"; transmissions.
The next business morning is the deadline for health plans. Electronic claim status requests provide your practice with an immediate status report rather than waiting two to three weeks. Checking a claim's status can help avoid many problems.
It is important to understand how checking a claim's status works and the different options for doing so. With this knowledge, physicians can be sure that they are getting accurate information about their claims and avoiding potential issues.
5. Simplify payment processing with electronic remittance advice (ERA)
ERAs hold the same details as paper explanations of benefits. Standardizing ERAs reduces burdens, identifies reworked claims, and lets staff focus on more valuable tasks. Implement ERA with all your trading partners, including health plans, your PMS vendor, and your billing service.
Check your PMS's ERA capabilities. A software upgrade may be required to take full advantage of ERA transactions. To ensure you cover all bases, you can use the STEPS Forward module to discuss the ERA tool.
If you're a physician who is fed up with the complex and time-consuming process of claims management, consider simplifying payment processing with electronic remittance advice (ERA). ERA automates many of the tasks involved in claims management, from claim submission to payment posting.
This not only saves you time but can also lead to fewer errors and faster payments. Contact us today to particularly learn more about how we can help you streamline your claims management process with ERA.
6. Collect payments from patients
Health plans are increasingly familiar with high deductibles, increasing patient financial responsibility. Getting payments from patients while they are still in your office is the first step in effective patient collections. Cash flow will increase, accounts receivable will decrease, and backend collection costs will drop.
Your staff will need to know the correct amount to charge during service. Pre-appointment eligibility checks provide information about patient costs. Calculate the patient's balance based on this information and the health plan's current fee schedule.
There are many reasons why physicians should consider collecting payments from patients. Payments can help to offset the cost of overhead, increase revenues, and improve communication between physician and patient. In addition, collecting payments can also simplify billing procedures and reduce accounting expenses.
Physicians who collect payments from patients often report feeling more satisfied with their work-life balance and having more time to spend with their families. If you are a physician considering whether or not to collect payments from patients, weigh the pros and cons carefully to make the best decision for you and your practice.
Final Thoughts
Revenue cycle management is crucial for the success of any medical practice. By following these tips, physicians can stay on top of their billing and ensure that they are being paid for the services they provide.
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