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Best Practices for Revenue Cycle Management (RCM)

Regardless of your practice size, specialty or location, healthy revenue cycle management (RCM) is critical to your business’s success. Essentially, healthcare RCM is the process your practice must follow to get paid for the care you provide. And we all need to get paid, right?

Unfortunately, maintaining an efficient RCM process isn’t easy. There are plenty of challenges stacked against private practices today — lower reimbursement rates, higher costs of business, staffing shortages and burnout are just a few. 

But it’s not all bad news. Following a few essential revenue cycle management best practices can get your practice in the black and on track for growth. And if you employ the right RCM software with your billing process — ideally one that uses automation — you’ll be well on your way to strong financial footing.

Best Practices for Revenue Cycle Management

Let’s dive into the revenue cycle management tips your practice should apply today.

Automate Insurance Verification

Verifying a patient’s insurance is the first and most critical step in the healthcare RCM process. If your patient doesn’t have valid coverage when they come in for their appointment, you’re not going to get paid.

Automating your insurance eligibility process can ensure your team verifies every patient before they enter the door. It can also cut back on time spent manually checking every patient’s insurance, which has become increasingly complex with new requirements from insurance companies.

Take a Patient-Centric Approach

When your practice has happier patients, you’ll see higher patient retention and more referrals. All that means more growth for your business.

But how do you take a patient-centric approach to healthcare RCM? Here are a few steps to consider:

  • Tailor your statements to your patient population. Patients are less likely to pay bills from an unknown or generic source. Make sure it’s clear your statements and estimates come from your practice. Customizing your statement messaging and cadence for your patient population can also boost engagement and payments.

Increase Revenue & Collection Rates

Gentem’s tech platform and team of billing experts increase practice revenue by an average of 20%. 

Improve Upfront Collections

Healthcare RCM consists of two halves: the front end and the back end. One of the main differences between these two stages is that you have more control over actions in the front half of RCM, as insurance companies and outstanding patient balances primarily dictate the back half. 

You can ensure timely payments when you control more of the RCM process, which includes upfront collections from patients. Payable estimates and payment plan options can help avoid delayed payments and revenue gaps.

File Claims Promptly

Although Medicare may give you a full year to file a claim from the date of service, many insurance companies have shorter time frames — usually 90 days. If you miss these deadlines, you’ll have to write off the claim and miss out on reimbursement. Plus, the faster you file a claim, the less time you have to wait to get paid.

Modernize Your Claim Process

Denied and rejected claims are a costly problem for any medical practice. But investing in modern, AI-driven technology can help your team submit cleaner claims and maintain a steady cash flow into your business. 

Some RCM software solutions provide customizable, automated workflows that edit and scrub claims for your team based on specific criteria. This powerful resource can not only limit manual coding errors, it can also save your team time on tedious billing tasks. That means they can spend more resources on patient-facing responsibilities that affect the growth and reputation of your practice.

Define and Track Your RCM KPIs

Revenue cycle key performance indicators (KPIs) help you gauge important financial metrics that show the health of your business. Keeping track of these KPIs help you monitor the cash flow that keeps your business running. KPIs can also reveal problems with your revenue cycle and highlight areas for improvement.

Some of the most critical RCM KPIs include accounts receivable (A/R), charge lag, cash collection, denial rate and rejection rate. Read and download this free RCM KPI guide to learn more and see how your practice meets industry benchmarks.

Revenue Cycle Management Best Practices Help Your Cash Flow and Your Team

Optimizing your practice with these revenue cycle management best practices can be a boon for your bottom line. With a streamlined reimbursement process, you’ll see fewer denials and rejections and reduced time-to-payment. In other words: better, stronger cash flow. 

Your in-house admin and billing team will also benefit from these revenue cycle management tips. Offloading tedious billing and coding tasks can help reduce burnout and give them more time to focus on your patients.

How Gentem Can Help You Practice with These RCM Tips

If you’re eager to implement these RCM best practices, Gentem will make it happen. 

  • How does Gentem help with automated insurance verification? Our real-time eligibility feature provides instant and reliable insurance checks for in- and out-of-network payers, helping you avoid costly denials. Your team can save time by setting up automated checks to batch-verify patients regularly. 
  • How does Gentem help with a patient-centric approach? You can improve patient experience and trust with Gentem’s text and email cost estimates. Gentem also allows you to customize patient statements and invoices, so you can tailor the messaging and cadence to fit your patient population. 
  • How does Gentem help increase upfront collections? With Gentem’s payable estimates, you can encourage patients to pay for care before the appointment or procedure. Plus, Gentem allows you to send the estimates via text, email or paper, so you can reach patients on their preferred channel.
  • How does Gentem modernize the claim process? Gentem uses machine learning and AI-powered workflows to automatically edit and submit claims. These tools will help your team avoid costly claim errors and save time on manual billing tasks. 
  • How does Gentem help define and track KPIs? Your team specializes in patient care, not translating complicated reports. Gentem provides easy-to-understand dashboards with the metrics that matter most to private practices, giving you a clear picture of your financial performance.

Ready to see how Gentem will improve your revenue cycle? Book a custom demo with our team today.  

WATCH: Revenue Cycle Tips for Staying Independent

Many physicians are leaving private practice due to rising costs, lower reimbursement rates and staffing shortages. But staying independent is possible with a healthy revenue cycle.

Learn how to run a successful private practice with tips from this 20-minute webinar session.

eBook Cover for 5-Must Know Metrics To Build A Thriving Medical Practice

5 Must-Know Metrics To Build A Thriving Medical Practice

With this free guide, you’ll learn the key metrics that inform your practice’s financial performance and how best to optimize them to support practice growth.

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