What role should RCM play in the HME billing industry?

You may have come across yet another three-letter abbreviation, Revenue Cycle Management (RCM), in this acronym-heavy HME billing industry. It stands for revenue cycle management, and it has the potential to transform your business.

Don't mix up Revenue Cycle Management and Medical billing

Billing is the process of submitting claims to reimbursement sources such as Medicare or private payer plans and then following up with those funding sources to ensure that the claims are paid. RCM encompasses much more than that.

RCM includes billing and claims administration, but it also optimizes:

• How claims are denied?

• How patient co-pays are collected?

• How much staff time is spent on claims?

RCM tracks the revenues and expenditures associated with a patient's relationship with a healthcare provider from start to finish. RCM is the umbrella term for all revenue management and optimization.

RCM has now made its way to the HME billing industry. In some ways, it has already been here, thanks to the proliferation of software tools and services in the HME billing industry. However, HME software suppliers have begun to collaborate with providers in earnest to define how RCM should function in the HME billing market to help providers redesign their overall revenue performance, not just their DME/HME billing.

Technology Tools

The Software has changed claims and operations management for HME billing organizations, and those systems are now integrating RCM technologies. The purpose is to assist owners and operators in monitoring and managing their revenues in a more proactive manner that is consistent with the overall operation of the organization.

However, because RCM is new to DME/HME billing department, there is a learning curve. While big healthcare companies may have created RCM procedures that have become routine, considerable work remains to be done in terms of outlining RCM workflows in the HME billing market.

As a result, there is some back-and-forth between providers' RCM learning curves and the soft skills. The current migration to RCM is essentially comparable to the HME billing and business management software deployment that HME providers went through a decade or so ago; it's just a different procedure and technology learning process.

Review Your Software

Once a provider has implemented RCM tools, it must guarantee that it stays current with technology. Following the initial investment and implementation, it is vital to ensure that an RCM system continues to pay for itself over time.

Every software business in the market, especially those developing RCM solutions, is working to guarantee that their products stay up with developments in not only HME and post-acute care, but the healthcare world in general.

Keeping this in mind, it is critical that an HME provider's management form a team of employees. It is to examine the RCM software regularly to determine whether:

• New features

• Updates

• Tools

Are all available to assist them in improving their RCM.

Outsourcing

Another alternative, in addition to installing new software solutions, is to outsource portions of the RCM process to third parties. Several third-party companies that serve the HME billing industry specialize in specific aspects of invoicing and claims processing.

Furthermore, these RCM outsourcing businesses frequently offer service niches to assist providers in offloading as much or as little as they require. This allows a provider to outsource specific aspects of its business that require labor they do not need to keep all of the time. A provider, for example, could outsource

• Cash posting

• Rejection management

• Accounts receivable

• Data input

• Fax handling

This allows the provider's full-time employees to focus on their main missions.

As outsourcers handle considerably more DME/HME billing claims or collections than any single provider, they begin to identify efficiencies that most providers do not, and they create best practices that a provider would take much longer to discover and adopt.

Since it is not focused on a specific specialization, an outsourcer may have a broader viewpoint and breadth of information and abilities. Essentially, they are gathering expertise from throughout the post-acute RCM spectrum and presenting it to their clients.

Key Points to Remember:

• RCM began in large healthcare organizations but has since spread to DME/HME billing sectors.

• RCM strives to match a healthcare business's revenue-related activities with all other workflows it may follow, such as the patient inflow.

• Software vendors in the HME billing market have been attempting to develop RCM solutions that HME providers easily integrate into their companies.

What’s the role of Sunknowledge in the DME/HME Billing Spectrum and how it affects the RCM?

Sunknowledge's advantage will help you maximize your ROI! Our team believes in serving as a dependable operational extension for some of the well-known names in the DME/HME billing industry. Working with us will provide you access to our specialized account management and personalized reporting standards, which are our trademark of trust and competence. As a HIPAA-compliant destination, we optimize your cash flow by providing unequaled pre and post DME/HME billing support in the industry.

Sunknowledge Services Inc. is committed to serve you as an extension of your operations with trust and excellence. We have a footprint that stretches from east to west, work across jurisdictions, and provide end-to-end assistance with highest operational transparency and productivity requirements.

With rates as low as $7 per hour and high production standards, we claim to save DME/HME billing costs by 80%. In addition, we provide unrivaled freedom with no binding contracts, specialized account management, and tailored reporting. Sunknowledge Services Inc provides you with a comprehensive RCM experience.