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Revenue Cycle Management

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danibrittany64:
Revenue Cycle Management includes the clinical & administrative functions which aid in capturing, managing, and collecting revenue from the delivery of patient service.

BikhamHCare:
Here are some important steps in revenue cycle management.

Schedule with accuracy: We want to know the right information time a  patient is scheduled seems pretty standard, it is a task many centers struggle with. If you don’t get it right the first time (patient name, insurance numbers, birthdate, etc.) a lot of time will be wasted later chasing it down, which can potentially result in denied claims and delayed collections. Unfortunately, the demographic and insurance information supplied by physician offices is sometimes incorrect.

Online pre-admission technology can assist with ensuring accuracy. Enabling patients to complete their medical histories (including demographic and insurance information) at a time and place that is convenient for them typically yields more accurate information. Systems like One Medical Passport offer facility-wide secure access to pre-admission information which is very helpful for nursing staff and the billing department.

Perform benefits verification in advance: Making sure a patient has coverage well in advance of a procedure will allow you to identify any potential issues up front. If an HMO patient doesn’t have a referral, the claim will be denied and you won’t be paid. There are several online sites that can assist with insurance verification. For example, the cloud-based EASE eligibility application tracks insurance data, surgery coverage qualifications, and benefit details.

coding and billing success: While coding and billing is something that can be successfully outsourced, particularly for those centers without the software, staff or space to do it themselves; for those that opt to keep it in-house, a clearinghouse is a must. Partnering with a clearinghouse typically results in claims being processed more quickly and with greater accuracy. A clearing house’s responsibility is to ensure everything is properly formatted and that files are transmitted to the insurance carrier in a timely manner. Look for a partner that can integrate with your existing revenue cycle management software such as ZirMed and SourceMedical. The ability to pull information already entered into a center’s existing software eliminates time spent on manual data entry and ensures accuracy which minimizes costly billing delays.


Go electronic: With the exception of some worker’s comp submissions, electronic billing, electronic remittance, and electronic remittance advice (EOBs) are the standard today. The move to electronic billing will accelerate a center’s cash flow as well taking advantage of electronic remittance. With electronic remittance, insurance companies directly deposit payments using electronic funds transfer rather than mailing a paper check. Anything that eliminates paper, postage and manual processes is best.

Plan ahead for ICD-10: Because coding will be more complex when ICD-10 takes effect, you want staff that is not the only current on coding, but understands the increased level of detail required by physicians; physician education is equally as important to ensure all necessary details are provided within the physician’s operative reports. Inquire with your software vendor to make sure they are ready for the conversion. Because hiccups are likely to occur, consider opening a bank line of credit.

PMRNC:
Here we go.. more from offshore  :o

Michele:

--- Quote from: BikhamHCare on April 05, 2018, 03:33:09 PM ---

Plan ahead for ICD-10: Because coding will be more complex when ICD-10 takes effect, you want staff that is not the only current on coding, but understands the increased level of detail required by physicians; physician education is equally as important to ensure all necessary details are provided within the physician’s operative reports. Inquire with your software vendor to make sure they are ready for the conversion. Because hiccups are likely to occur, consider opening a bank line of credit.


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ICD10 was implemented a year and a half ago.   ???

PMRNC:

--- Quote ---ICD10 was implemented a year and a half ago.   ???

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Meitsnay thinka datitsa offshorkay   :o ;)

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