The process of managing claims processing, revenue generation and payment is called revenue cycle management and there are plenty of revenue cycle companies that are offering such service. In their service, this includes everything from collecting co-pay, determining the eligibility of patients, coding the claims, collecting payments, tracking claims and even doing follow ups on denied claims. Revenue cycle procedure should be efficiently managed as it is an integral part of any office functions.
Because the focus is gradually shifting towards changes in reimbursement methodologies, increasing transparency and containing healthcare costs, financial pressures do increase as well on healthcare organizations in the upcoming days. According to research and surveys, it showed that revenue cycle companies have almost rejected 26 percent of all the claims submitted. The 40 percent of rejected claims aren’t submitted to CMS. Because of that, there are various healthcare organizations that lost revenues. It doesn’t matter how popular and good an organization is, because in the end, it will certainly affect the way an organization is operating on a day to day basis.
On the other hand, as you work with experienced revenue cycle companies, you can be certain that they are going to place appropriate RCM procedures which makes it possible for an organization to enhance their bottom line while reducing their write-offs. Some common issues that are faced by organization in their RCM similar to poor communication between workers, untrained staff and incorrect workflow can be corrected easily in-house.
On the other hand, it can be overwhelming for other organizations to take on the responsibilities and duties of revenue cycle management. Well fortunately, there are a number of revenue cycle companies that are able to take over the whole responsibility and duty of managing the revenue cycle of your organization.
Choosing the appropriate revenue cycle management firm requires you to have thorough understanding of revenue cycle market and broad knowledge as well. Believe it or not, at 2014, revenue cycle market was valued at almost 18.3 billion dollars but by the end of 2019, it is expected to grow by 32.2 billion. In other words, you can expect to see better companies and products to meet your needs for revenue cycle management.
Following are key indicators to be known and understood in taking advantage from this growth and this includes building strategy to be focused on consumers, pharmacies become margin generators and key revenue, work towards eliminating the cost of collecting bills of patients, building a strategic partnership with RCM providers in order to reduce cost of operation and also, to cope up with tricky reimbursement rates and many more. As you learn about this, you can be certain to find good revenue cycle companies to be hired.