Effective RCM Process Plays Major Role in Medical Billing 2021

Medical Billing is the process of submitting claims with insurance companies and follow-up for reimbursement. Revenue Cycle Management not only deals with claim submission for reimbursement, but it is also a complete cycle of the process which manages the entire clinical function data, financial transaction from various channels and administers the entire cycle from Patient scheduling to final payment. With the after-effects of COVID 19 and pandemic, there has been an overhaul of updates and changes in the Medical Billing and Coding guidelines increasing the challenges involved in successful Billing. Having an effective RCM process in place helps achieve the targeted bottom line of the practice and improve patient care.

Effective RCM with Simplified Process

A simplified and modernized approach is the key to successful Revenue Cycle Management Services. Efficient and user-friendly billing software and tools, experienced administrative staffs, trained and skilled billers and coders, Regular audits ensuring KPI achieved are some key requirement for the lasting success of any practice. The benefits of having an effective RCM is evidently visible as:

• Faster and consistent Cash flow

• Increased Efficiency

• Increased Productivity and Quality

• Reduces denials and Accounts Receivables

• Increased cleaner claim submission and First pass rate

• Reduced cost by eliminating redundancy

• Streamlined approach

• Increase Net Revenue to the Physician or Practice

KPI’s For Better Insight of Revenue Cycle Management

Key Performance Indicators (KPI’s) help analyze your practices’ financial performance and quality care. Having metric driven process in places is imperative to ensure long term success and growth. Listed below are some common metrics or KPI’s to closely monitor your Practices’ performance and financial goals.

1. Collections per visit

2. Billed amount consistent with updated fee schedule

3. Percentage of claims First Pass Rate

4. Denial or Rejection Percentage

5. Aging AR percentage by days in AR

6. Percentage of your uncollected bill

7. Non-Contractual Write-Offs

8. Monthly Gross Collections vs. Net Collections

9. Comparison of Monthly collection with previous month to monitor areas of Improvement.

Keeping a close track on the above list can help any practice with a detailed understanding about their progression.

Medical Billing and Coding Software and AI Applications

Investing in an updated and latest AI interface to automate system for most of the data entry and coding process and help eradicate common man-made errors. This also reduces manual tasks saving from cost related to human involvement. It is to be noted that advanced AI applications provide advanced analytics that supersedes manual reporting, meeting the requirement for metric driven process in place.

Services That Enhances your overall Billing Experience

Apart from the core Medical Billing Services, it is also essential to closely monitor other areas which can impact your RCM process and Quality patient care. Listed below are few areas that can improve your overall billing experience

Insurance Eligibility and Benefit Verification: Verifying Insurance Eligibility, Benefits and coverage details prior to patient care can reduces denial percentage due to missed or incorrect coverage and benefit details. Medical Practices and physicians have to ensure this is an integral part of their billing process to avoid unnecessary delays in claims processing due to improper coverage information.

Physician Credentialing: Having your Physician credentialed with your Payer network is essential to gain trusted patients and to attain your financial goals. Having Credentialing Physicians on board not only increases your reputation in the market it also reduces your risk associated with lawsuits by healthcare providers with previous malpractice history. To ensure the quality for your patient care in your practice, physician credentialing is mandate.

About MGSI

Outsourcing your RCM process to one of the top Medical Billing Company in the nation can prove to be the best choice to achieve the benefits mentioned above. MGSI is a 25 year old national Medical Billing Company serving more than 600 physicians across US. MGSI has trained and experienced medical billing and coding team handling complete revenue cycle management services to our clients. To know more about the benefits of outsourcing your RCM process to MGSI contact us today