Everyone knows that hospitals and larger
health care systems are working dedicatedly for saving lives by treating the
patients. Therefore every healthcare organisation is supposed to create
successful processes and policies for keeping themselves financially healthy. However,
for this to happen seamlessly the integration of Revenue Cycle Management
Service (RCMS) is necessary.
RCMS can be defined as the financial
process that is used in method to managing the administrative and clinical
functions that are associated with claims processing, payment, and revenue
generation. The process of Revenue Cycle Management Services is carried out by
using medical billing software and practise management services that
effectively helps in tracking the claim processes with the accurate date.
In this context, our company Medical
Billing Outsourcing is offering accurate, timely billing and coding services by
the aid of professional billers. Our company is using the latest technology for
increasing the revenues thereby accelerating the patient's cash flow. Without
using Revenue Cycle Management Services healthcare providers maintain the
strategy to pay the bills and treat patients.
PROCEDURE DONE IN REVENUE CYCLE MANAGEMENT
SERVICES-
The Revenue Cycle Management Services starts
when a patient makes an appointment for its treatment under a doctor and
finally terminates when all the payment related to claims and patient payment
are cleared.
After a patient takes an appointment with
the doctor, the administrative staff starts the process step by step that
includes scheduling, insurance eligibility verification, and opening patient
account. Pre-registration is done to optimize the healthcare revenue cycle
management processes accurately. Here the employees create a patient account
that renders all information addressing medical histories and insurance coverage
in overall.
The pre-registration process helps the
claims to be billed in timely manner thereby maintaining accuracy. After the
claim has been submitted by the patient, the healthcare provider or the coder
starts identifying the nature of the treatments received by the patients and
analyse it through proper ICD-10 code.
These codes help to identify how much an
entity should get reimbursed for highly specific treatments that are given by
the hospitals. In this, using an appropriate medical code will help in reducing
claim denials.
Once a claim is created, the next important
step is to send it to the private or government payer for reimbursement.
However, healthcare organisations still are in demand to cross verify and look
after official work associated with claims reimbursements. This procedure
includes payment clearance, statement processing, collections, and handling
claims denials more efficiently.
After the insurance company successfully
evaluates the claim the healthcare organisations take forward the reimbursed
services by verifying patient's coverage and payer contracts from details
submitted.
In some cases, claims can be denied because
of the reason of improper coding, or missing items in the patient chart, or
incomplete patient accounts information. Therefore it is highly recommended to
give valid code while processing the bill clearance for the patients. Our
company Medical billing Outsourcing Services helps the organisations in getting
the full payment quickly.
