Audit Your Revenue Cycle Management (RCM) for Improvements

Audit Your Revenue Cycle Management (RCM) for Improvements

In the Healthcare business, it is believed that about 25% of denied claims are never reimbursed at all, practices dealing with this problem lose a high percentage of revenue throughout the year. If your practice rejection rates are extremely high, then this concern must be addressed and administered so that your practice can continue to manage clients and generate money. Examining and analyzing your practice’s revenue cycle is among the most profitable strategies to identify how to avoid such rejections.

Revenue cycle management (RCM) is one of the most complex medical office tasks. There are some steps involved in the process and some barriers maybe come across in the entire process. But there are ways to apply the standard principles of professional RCM to improve your practice ability to get paid in a timely manner.

Let’s understand how to evaluate and how Zee Medical Billing may assist you in optimizing your revenue cycle for practice growth.

Why Is Insurance Claim Being Denied?

According to Medical Group Management Association (MGMA) statistics, there are several reasons why insurance claim payouts are refused. The most common reason is a lack of or incorrect information, such as:

  • demographic data
  • procedure codes
  • diagnostic codes
  • failure to meet medical necessity criteria
  • payer processing mistakes
  • treatments not being paid (eligibility problems)
  • the practitioner is out of the community benefits integration.

Rejections are a problem for healthcare practitioners as they can force the billing team to analyze and resubmit the request and loss in revenue generation. Rejection rates can be significantly reduced by analyzing a practice’s revenue cycle.

How to Evaluate Revenue Cycle?

A thorough revenue cycle analysis will assist your practice in avoiding claim rejections and ensuring that you get regular compensation for services provided. Greater profitability is the most important advantage of decreasing denials for your business.

The revenue cycle analysis should involve a glance at the following components:

Current Revenue Cycle Processes

While analyzing the billing process, you should also focus on the process. The revenue cycle is complicated, starting with the registration process and concluding with insurance follow-up. Inspecting the process and duration for completion of each step of the process will help you analyze opportunities for improvement by viewing the process from start to end.

Applied Revenue Cycle Resources

Utilizing certain technologies is definitely a part of the profession’s revenue cycle. Along the way, investing time is required for identifying which materials and resources are used for the respective activity. It is important to know the views of your team about how the procedure is handled and which resources are most effective to them.

Major Performance Metrics

You must be well-versed in your practice’s key performance metrics to properly comprehend your revenue cycle. Once these have been identified, consider net recycling rate, days in receivable accounts, and other performance measures compared to industry best practices. This kind of evaluation will help your approach to discover areas for improvement in the future.

Staffing Plans

The plans should also evaluate the firm’s workforce levels. Explore procedures with your team and set up the people needed at each stage of the process and how much time is spent affected by variables such as patient information, specialty, and needed technology. You can avail this opportunity to handle any future personnel demands that may begin due to your new goals.

Zee Medical Billing Revenue Cycle Management (RCM) Services

Complete evaluation of the revenue cycle may greatly reduce the number of insurance claim rejections in your practice, leading to higher income and overall practice productivity. Zee Medical Billing’s skilled team specializes in revenue cycle management for medical billing, and we are here to collaborate with you to help you thrive.

Our RCM services prevent refiling expenses and reimbursement waits, reduce delivery time, and maximize cash flow. Zee Medical Billing’s dedicated team also provides an expert opinion for your practice, allowing you to get ideas into what needs to be addressed and make the required adjustments moving ahead.

We at Zee Medical Billing provide a wide range of practice management services to uplift your practice. Get a free no-sting attached billing services quote from ZEE Medical Billing for your practice.

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