Revenue Cycle Management’s Importance in Healthcare

The Healthcare industry transition from fee-for-service to value-based care reimbursement impacts the traditional RCM (Revenue Cycle Management) in different ways. Every healthcare organization or an individual veteran practitioner needs to be financially balanced or strong to deliver their uninterrupted services. This is a time where best healthcare RCM service comes in.

Revenue Cycle Management in healthcare is the financial process that facilitates the control of complex administrative processes and clinical functions such as patient eligibility, claims processing, reimbursement, denied claims management, and revenue generation.

RCM is the backbone of healthcare organizations that helps them to pay their bills, manage their resources and much more. According to international standards report, in medical billing, more than 25% of claims have been rejected and up to 40% of those claims are never re-submitted i.e. the healthcare organizations suffer from major revenue loss.

On the bright side, with proper RCM process, the healthcare sector can get greatest benefits with minimum bad debt write-offs. To understand the exact phenomenon of healthcare revenue cycle management, first, you have to understand its basics in the medical billing process.

Basics of Healthcare RCM:

It starts from the appointment of a patient to seek any medical assistance and completes when the health organizations collect their payments.
At the beginning, the health group administrative staff manage an array of processes like scheduling, insurance eligibility verification and creation of patient’s account.
“From the perspective of Revenue Cycle Management, immaculate submission of patient information at the time of patient scheduling and registration improve the cash flow of the healthcare organization.”
After the patient’s treatment, the process of claims submission begins. An advanced coder submits the claims with right ICD-10 codes, the codes define the value of reimbursement and an approved code prevent claims denials.
Then comes the important part of private or government payer for payment. They evaluate the claim values, verify the details i.e. insurance coverage, contracts, etc. and process for reimbursement.
Most claims are denied due to improper coding, incomplete patient accounts, patient chart errors, etc.
Then comes the last outcome of revenue cycle management i.e. maximum claims reimbursement. RCM helps the healthcare organizations to get paid maximum claims reimbursement on time with fewer denials.
After that, the healthcare groups or the individual veterans perform the AR Follow up in which they create Healthcare claims i.e. manually or automatically and sends them to various Insurance companies.
In the final stage i.e. Payment Posting, the medical billing management software records every patient’s payment with accurate information including patient’s name, account number, denial info, service dates, etc. for future reference.
Importance in Healthcare:

It can help the healthcare organizations to track the exact performance of their financial growth. They can easily determine the claims approval and denial rates via proper RCM process. With immaculate RCM process, the healthcare organizations managed their medical billing process effectively and fixed their claim denial issues quickly.

Here are some key benefits of effective RCM:

Fewer denied claims
Improved patient care
Higher Reimbursements
Immaculate administrative records i.e. no other penalties or fees
Faster Turnaround time for claims payments

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All About the Healthcare Marketing Industry

The healthcare domain is vast and spread across various other sub- domains. Not only is it fragmented, but it is also complex. The industrial scenario is extremely skeptical with emerging players in the market environment. A lot of factors have contributed to this skepticism such as the population rise and exhaustion of resources. Funding for healthcare has always suffered the brunt of economic depression and hence has always been in short supply. Competition is rampant and is only increasing with the advent of new healthcare organizations.

The healthcare marketing industry

The healthcare industry is a dynamic environment that employs a wide range of marketing tools. The marketing tools are used for brand promotion or for reinforcing a brands image. The increase in the growth and development of the healthcare sector has caused many marketing firms to diversify their operations across various sub-domains and project themselves as specialists in the domain. However, certain marketing firms treat healthcare marketing as a part of their diverse operations with no unique specialization attributed to it.

Tools used in healthcare marketing

1. Sales/Networking- This constitutes development of an extensive network, going where the market is, building presentations and showcasing your skills.
2. Direct marketing- This involves the use of letters, patient leave back leaflets, fliers, brochures etc.
3. Advertising- Advertising makes use of print media, outdoor and out of home advertorials, special publications, etc.
4. Use of Free media- Free Media involves writing expert reviews and articles for TV channels, news media, etc. With this you can establish a name for your organization and be known as an expert.
5. Build strong Public relations- Consider supporting a social cause. It will help build your brand’s reputation as well contribute to the society at large. It helps build good will in the community at large.
6. Use of social media and the internet- Social media services and the growing popularity of the internet have taken marketing to the next level. The presence of online healthcare portals has further pushed the need for an organization to develop new and innovative strategies to woo customers.
Appropriate use of these tools would lead to a direct increase in sales volumes and generate revenue for the organization.

Effective use of Press Release

Press Release (PR) is one of the most effective tools for healthcare marketing. It is widely used to communicate news of your business and create awareness of product launches.

Telemarketing
Be it cold calling or hot calling, telemarketing continues to be employed as a healthcare marketing strategy even today. Yes, its use has diminished, but it hasn’t disappeared. This highlights the fact that even though the healthcare industry is not as aggressive as advertising in other sectors, the traditional methods of advertisement would still contribute to the growth of the healthcare industry.

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