Revenue cycle management ensures the physician that he or she will get paid for the services rendered and that the payment will occur within a timely manner. Gone are the days of providing health care services to patients only to hope and pray that your services will be paid for. There is no more guesswork when a revenue cycle management system is in place.
The revenue cycle begins when the patient first calls the doctor’s office and makes an appointment. At this time, the staff member captures the patient’s name, date of birth, phone number, and insurance company name. The revenue cycle ends when the patient’s balance is zero and not a moment sooner. The initial phase of data collection is crucial to the success of the system. Although some offices claim that they cannot afford to take the time on the phone to collect pertinent patient information, when the accounts receivable balance fails to reach zero, they may wish they had.
When an office gets verification of the patient’s insurance prior to care, efficiency is set in motion. For example, in an office where verification was not made, a patient room must be held up prior to and at the time of check-in to await verification. This practice can push the entire schedule behind for the day, all due to the lack of data collection at the time the appointment was made. This practice of data collection is often referred to as pre-visit eligibility and in order to keep the revenue cycle management process operating efficiently, verification must be made at this time. This process is considered to be a best-practice for physicians in every field of medicine. In the event that information was gathered showing the patient not covered by insurance, the appointment may be rescheduled or canceled altogether. This practice will benefit the doctor and the patient.
Another critical step in the revenue cycle management process is to ensure the right numbers are used in patient registration and billing. This means that there is a stressed importance of entering the correct CPT code and ICD-9 (soon to be ICD-10) diagnosis code. This should be done in a timely fashion to ensure there is no disruption in the process. Charge slips should not be held, as is common practice for many offices, even for one day.
Electronic claim submission and remittance can enhance the process of revenue cycle management and automation is the key to success. The more an office automates, the more time is saved among staff members as less time is spent addressing outstanding claims and past due balances. If your office is looking for a sure way to a zero balance that is highly effective and works in your favor to eliminate missing charges then revenue cycle management can help.
The process is effective if maintained the right way. If data is gathered upfront, eligibility is verified, the correct coding numbers are used, and the process is automated as much as possible revenue cycle management is found to be one of the most effective tools in medical practices today. Zero account balances are the goal and aim of any revenue cycle management system.