In today’s fast-paced healthcare environment, optimization of the patient-to-payment lifecycle is essential to the financial growth of any practice. Effective revenue cycle management (RCM) minimizes the time from patient intake to final payment, ensuring that hospitals and practices can continue to provide high-quality patient care without financial hindrance.
Challenges in Revenue Cycle Management
Three primary challenges stand at the forefront of RCM:
- Inefficient Billing Processes: Many practices still rely on manual entry, which can lead to errors and delays. Automated RCM services can reduce errors and speed up claim submission.
- Denials and Rejections: Claim denials are a significant hurdle, often due to incomplete patient information or coding errors. Modern RCM systems, powered by sophisticated algorithms, can preemptively identify and correct issues before submission.
- Patient Payment Delinquency: High deductibles and co-pays can lead to delays in payment. In fact, 48% of healthcare leaders from an MGMA study say that outstanding patient payments are the biggest challenge in the revenue cycle. Transparent billing and convenient payment options are critical in addressing this challenge.
Optimizing the Patient-to-Payment Lifecycle
To address these challenges, practices can partner with advanced RCM companies and employ the following strategies:
- Automated Eligibility Checks: By verifying insurance eligibility automatically at the point of care, practices can reduce claim denials. An advanced RCM companies such as pMD, can integrate automated eligibility checks and demographics verification directly into the appointment scheduling and charge capture process, ensuring coverage details are accurate and current.
- Intelligent Coding Assistance: Utilizing AI-enhanced coding tools can significantly reduce billing errors. Some RCM companies provide software that helps in choosing the correct codes, which streamlines the billing process and reduces denied claims.
- Patient-Centric Payment Solutions: Offering straightforward and transparent payment methods for patients encourages timely payments. For example, pMD supports multiple ways and devices on which patients can review their bills and make payments, enhancing the likelihood of on-time payments.
Automating for Efficiency and Revenue Growth
Automation stands out as the cornerstone of modern RCM solutions. By automating routine tasks, practices can free up valuable resources, allowing staff to focus on more complex issues that require human intervention. As we discussed in a previous post, automated insurance elegibility checks and demographics verification can significantly reduce charge lag and save the practice time, thus accelerating the revenue cycle.
How pMD® Can Help
At pMD®, our mission is to streamline and optimize the patient care episode and the revenue cycle. Through our advanced, end-to-end practice management and revenue cycle solutions, we can help practices consolidate vendors, reduce costs, streamline workflows, improve patient care and satisfaction, and collect their maximum reimbursement more quickly.
Not sure what a vendor could do to improve your behavioral health billing? Contact pMD® for a no-commitment financial impact analysis by our team of healthcare RCM experts free of charge!
To find out more about pMD's suite of products, which includes our charge capture and MIPS registry, billing services, telehealth, secure messaging, and care navigation software and services, please contact pMD.