Author Topic: how to improve rcm?  (Read 1026 times)


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how to improve rcm?
« on: May 07, 2021, 02:49:53 PM »


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Re: how to improve rcm?
« Reply #1 on: May 07, 2021, 07:04:59 PM »
You go do you think it can be improved? After you answer, then I will add my thoughts.


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Re: how to improve rcm?
« Reply #2 on: June 02, 2021, 08:22:31 AM »
A successful revenue cycle management process involves many steps, here are some of  them;

Improved Front-End
Verified Insurance Eligibility
Trained Staff


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Re: how to improve rcm?
« Reply #3 on: June 17, 2021, 09:32:26 AM »


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    • Medwave Billing & Credentialing
Re: how to improve rcm?
« Reply #4 on: October 01, 2021, 09:05:11 PM »
We just wrote an article on the subject.

10 Ways to Best Achieve Revenue Cycle Optimization

Utilizing the following best practices as everyday procedures can help minimize these problems:

  • Ensure the practice management system is assembled properly. Essential functions will comprise gathering of demographics, insurance verification, claim scrubbing, coding and charge capture.
  • Medical coding is the pillar of medical billing and revenue cycle. A modest coding mistake can mean rejection or denial of a bill and lead to long-term revenue loss. Pinpoint coding issues, carefully examine medical policy revisions and documentation questions and apprise appropriate persons.
  • Train staff for manual processes but automate as much as doable. Eligibility verification, appointment scheduling and claims scrubbing need to be automated.
  • Require timely payment posting – daily if doable – to guarantee exact accounts. Payments, discounts, denials and patient accountability should be completed daily with follow-up of all unpaid/denied claims.
  • Plan metrics to assess the practice’s achievements in the revenue cycle. Produce key performance indicators (KLPIs) and follow the trends. Create an action plan when negative trends emerge.
  • Pinpoint key revenue-affecting pain points and put policies in place to tackle them. Establish procedures to contend with underpaid/zero paid claims, when to appeal and when to write off and move on.
  • Monitor old accounts and accounts receivable days. Give precedence to unpaid accounts by balance due, payer and age, and cross-train staff to ensure performance objectives and fulfillment.
  • Denials are a part of the billing process and even the most precise and experienced billers encounter denials at some or other parts of their jobs. So, it’s critical for practices to keep up an appropriate denial management plan. It’s important to study the denied claims and look for possible reasons for the denial.
  • Generate coding and charge entry guidelines and identify the practice’s lag time from when the service was delivered to when it was billed.
  • Outsource your medical coding and/or billing to a qualified 3rd party group.
Lauren L.
Medwave Billing & Credentialing