What makes healthcare revenue cycle solutions the need of the hour? It is a well – known fact that the healthcare system in United States is experiencing. The worst financial tug it ever had due to the covid-19 pandemic. When the number of covid affected cases skyrocketed worldwide. We had the highest number of patients and it had its toll on every industry. The world is struggling to cope up with the aftermath of a massive financial breakdown. Saving your health care revenue cycle from crashing down is the most important task in hand.
Since the healthcare revenue cycle is already kicked off, making sure the patient keeps up the appointment is very crucial. Either have your staff call them with a reminder on the appointment or invest on automated reminder services which can send a text or a voice call to the patient regarding the time and date.
Health care revenue cycle Solutions
Health care revenue cycle is the crux of every profitable practice. It starts even before the time patient comes into the facility. Once the patient contacts the facility and schedule an appointment, the registration process begins. Type of registrations vary from facility to facility. These days, we see virtual registration forms like typable pdf online forms being given to the patients which they can fill up at their home relaxed. However, there are still practices who do paper registration forms which are filled up by hand, old-style and quite frustrating to the patient. Depending on age and other disease conditions, it can be tiresome for them to fill up handwritten forms. Completing the paperwork itself will take ages for the patient and your staff.
Having said that, bringing down claim denials with the help of healthcare revenue cycle solutions is the need of the hour since it can exhaust your hard-earned profit more than anything else. Its is a matter of paramount importance for you to be in the know of how claim denials happen. How they affect you and how to avoid rejections to improve the revenue cycle.
How does a claim get denied?
Sometimes, claims could get rejected too when there are coding errors and mismatch between documented procedures in them. When more than one error is spotted in the claim even before processing, companies simply reject the request.
How does a claim denial affect you?
Denied claim needs to be looked into again, and it means added administrative work. That’s additional workload on your clinic staff apart from their routine chores; so even the scheduled activities in the facility gets affected as a result. The more a claim payment gets delayed, there is significant reduction in revenue inflow.
Let’s look at how healthcare revenue cycle solutions help you avoid denials:
- Getting the information right at the first time – With advanced technology implementation. One can avoid data entry errors like date of onset, procedure dates, patient demographics, card details etc.
- Adhering to good coding practices – A common mistake causing revenue leakage is using wrong codes for the diagnosis and procedures. To rectify this error the documentation process at the clinic ought to be immaculate. The reason being; the claim did not validate the service provided.
- Saves you from another claim denial. Claim modifiers will be used too if needed to rectify the errors.
- Promptness in submitting claims- Certain government and private payers demand submission of the claim within a stipulated time from the patient visit. More than often, delays and forgetfulness from the staff might end up in failure to submit it on time.
- Thorough eligibility checks to verify coverage – It is a part of routine services provided at healthcare revenue cycle solutions. Payers keep revising their coverage plans and packages, but patients are probably not aware of this. After receiving a treatment which was duly covered the first time, patient normally expects reimbursement the next time too. But that may not be the case according to the revised regulations of the insurance company. the patient should be informed and advised on other treatment options. Also, the provider can rest assured their service is eligible for payment.
Most often this step is ignored, and the entire healthcare revenue cycle gets delayed resulting in loss of income. Every rejected claim should be revised and fixed as quickly as possible to on a regular basis to ensure smooth running of the revenue cycle. Healthcare revenue cycle are that safety harness on your practice, preventing claim denials from happening. Because every patient matter and every claim matter for a flourishing practice.
