Revenue Cycle Management Vendors Help You Ditch Those Outdated RCM Processes
Outdated and ineffective revenue cycle processes cost healthcare providers billions of dollars annually, according to the Medical Group Management Association (2021). The industry could have saved $20 billion in 2021 by automating administrative transactions, or 48% of the $42 billion spent on transactions tracked by the 2021 CAQH Index. If you’re reading this, it’s time to review your revenue cycle processes and employ management vendors to get your bottom line back on track.
Are You Still Using These Outdated RCM Processes?
Clunky, inefficient front-end operations that lead to delays or revenue loss. Automate the front-end process, including gathering documentation and prior authorizations, to cut down on administrative costs. Keep front-end staff updated on payer guidelines and regulations.
Reconciliation efforts that do not have coding accuracy or the provider’s bottom line in mind. Providers need to follow a strict process for reconciliation. This includes ensuring the coding is done accurately, gathering all documentation, and billing the payer in a timely manner.
An outdated chargemaster that does not provide the current allowances per payer. Providers can ensure their chargemaster remains accurate by obtaining complete payer contracts and updating the necessary coding and billing software to include the payer’s guidelines.
Ignoring your high-dollar claims and failing to follow through to ensure full payment. Providers should prioritize turning around their high-dollar claims within 30 to 60 days to avoid delays and potentially lose revenue.
Low (or non-existent) coding accuracy standards that contribute to coding errors. If organizations don’t uphold their coding teams to a quality standard of 95% or above, they run the risk of compliance issues, errors, delays, denied claims, and lost revenue.
Infrequent coding audits won’t catch errors or areas for improvement until it’s too late. Regular audits, at least on a quarterly basis, will help minimize overcoding and undercoding occurrences. Audits will only help strengthen your coding team’s skills and knowledge, preventing billing delays and denied claims before they start.
A high DNFB (discharged, not final billed) rate with no improvement plan in place to address it. DNFB accounts are one of the biggest revenue-killers for providers. The key to combating DNFB is through detailed trending reports and experienced consultants who can harness their power into actionable strategies.
YES Can Be Your Next Revenue Cycle Management Partner Vendor
Our quality coding and auditing experts have the specific skills necessary to jumpstart your revenue cycle management processes. With our coding, auditing, and education services, your organization will be well on its way to gathering more accurate, timely payments. Connect with our team to discuss your needs.