Do you plan to include the most advanced healthcare revenue cycle management for your organization? If you're planning to outsource some of your medical billing to these organizations, you may wonder what tasks they'll take over and what you'll still have to do in-house. With healthcare debt recovery services, you won't have to worry about a thing when it comes to claiming submission, patient follow-up, or communication with insurance companies.
Bills and claims submission
Here, the core service automates the billing and claim submission process where you can integrate the electronic medical records (EMR) system, pulling each visit's details, relevant patient information and other data directly into a standardized claim form.
The revenue cycle management services run a series of claims scrubbing tools over each claim. This must be sent to a payor to ensure the information is complete and the appropriate codes are utilized to provide maximum reimbursement.
In addition, if the claims get denied, the team handles all the essential follow-ups, resubmitting claims and escalating issues to ensure your practice always gets the revenue you count on.
Verification
It's infuriating to discover that your service to a patient may not get covered under their specific benefits. Unfortunately, this leads to denied claims and amounts in accounts receivable remaining far longer than they should. Healthcare debt collection services will help the team get the right question to determine whether the insurance plan covers certain services before you run them.
Credentials
If a new physician or treatment is rendered in the team, or you plan to contract a new payor, the revenue cycle management services will handle all the credentialing. Here, the firm covers commercial payers as well as government payers, i.e., Medicare, Medicaid and VA insurance.
A professional firm will keep operational staff and providers updated. In addition, they'll ensure you don't miss out on reimbursement due to not having credentials.
Reviews utilization
Apart from verifying patient benefits, it's essential to obtain authorization from the payors. This is especially vital when you're unable to contract for specific codes. The insurance landscape is confusing. Moreover, it's constantly changing; as a result, the experts will advocate on behalf of insurers to guarantee maximum reimbursement promptly.
Payment collection
Another time-consuming task the staff handles on a daily basis is when interacting with the consumers. Healthcare debt collection services will reach out by phone, e-mail, and mail to secure these payments, freeing the team to handle other essential tasks.
Account receivable management
The latest revenue cycle management services help constantly monitor the practice's accounts receivable to see which outstanding payments are to be received. You can pursue the payor or patient who owes the balance. The service provider also posts payment in a timely manner and equally records both paper and electronic filing for the records.
Reporting
Medical billing companies must ensure access to the most up-to-date financial information. This is especially when regarding the services they offer. For example, during the reporting sessions, the healthcare debt recovery services will go over the claim submission, acceptance rate and the state of accounts receivable, especially the transaction during the process.
Final takeaway
It's best to outsource tedious tasks if the team's attention takes away from providing excellent care. Therefore, the expert team's sole focus and expertise are in revenue cycle management. With the integrated, streamlined approach to patient access, the overall management helps identify and solve the problems that impact revenue.
When you ensure a consistent approach with standard workflows that catch errors in real-time, as a result, you can now optimize existing investment and operations for fast, measurable ROI.