Are you experiencing delays in your insurance reimbursements? A lot of healthcare providers are struggling with claims denials in payment processing, slow payments, or billing mistakes.
These issues affect cash flow and add an unnecessary burden on administrative staff. Revenue cycle management services can help healthcare professionals improve the process of processing claims to reduce the chance of errors and ensure timely payment.
Continue reading to find out the ways that revenue cycle management could improve the processing of insurance claims.
Steps Involved in Revenue Cycle Management
1. Patient Registration and Insurance Verification
The first step of claim processing is to collect precise information about the patient. This includes personal information as well as insurance policy numbers and verification of coverage. The errors in this stage can result in denials of claims or delays in payment.
Insurance verification confirms that the patient’s insurance policy is in effect and covers the necessary treatment. Verifying this information prior to providing services will prevent billing issues for both the provider and patient.
2. Medical Coding and Charge Entry
Medical coding assigns codes that are standard for diagnoses, treatments and procedures. Insurance companies employ these codes to calculate the amount of reimbursement. Incorrect code can result in payment denials or insufficient payments.
Charge entry is the process of entering billing information in the software. Any small oversight in the coding or pricing could result in a claim being rejected. Making sure that the codes match with the service provided is vital to ensure smooth processing.
3. Claim Submission and Processing
After coding and billing is completed, claims are then sent to insurance companies to be processed. The speed of processing is crucial in this process. In the event of delays in submission, it gives insurance companies time to scrutinize and then deny claims due to incomplete details.
A lot of healthcare facilities are now using electronic claims submissions instead of paper-based documents. Electronic submissions increase accuracy, decrease turnaround time and allow for quicker corrections in the event of errors.
4. Denial Management and Resubmission
Denials of claims are commonplace when it comes to medical billing. Reasons for denials include incorrect patient details, coding errors, or missing documents. Instead of accepting rejections of claims as a loss of revenue, healthcare providers should examine and correct the mistakes.
A solid denial management system monitors common causes of claims being rejected. The ability to identify trends in denials will help users correct the issues before submitting claims for the next time, thus reducing the rate of rejection.
Making sure claims are submitted promptly reduces the risk of revenue loss.
5. Payment Posting and Reconciliation
When payments are made the funds must be correctly registered in the system. This ensures that all payments are in line with the amount of the invoice and that any rejections or underpayments are investigated.
Reconciliation involves comparing the expected amount against actual reimbursements. If there’s a discrepancy medical professionals must notify the insurance company in order to resolve the problem. The process of tracking payment due and sending reminders can help keep track of balances for patients.
How Revenue Cycle Management Improves Insurance Claim Processing
A well-designed technology for managing revenue cycles plays an important part in making the process of processing claims more efficient. This is how:
1. Fewer Errors and Faster Payments
Coding and billing errors are the most common cause of rejections on claims. A robust RCM system can reduce errors and reduce the number of claims that have to be resubmitted and corrected.
This improves the speed of payment processing and makes sure that health care providers get reimbursements in time.
2. Increased Approval Rate for Insurance Claims
A clear and accurate documentation, the correct code and timely submission enhance the likelihood of approval for claims. If healthcare providers adhere to the best methods of RCM insurance firms are less likely to deny claims due to incomplete details or mistakes.
How PerigonMed Can Help
The effective management of the revenue cycle requires expertise, knowledge and constant monitoring.
PerigonMed offers professional revenue cycle management services that aid healthcare professionals improve the process of processing claims and increase reimbursements.
From patient registration through the final payment collection, PerigonMed makes sure that each step through the entire process has been executed efficiently. Our team is focused on precise Coding, quick claim submission and proactive denial management to reduce the loss of revenue.
Take the Next Step
Insurance claims management doesn’t have to be difficult. If you’re looking to improve claims approval and assure an efficient revenue management process, PerigonMed is here to assist. Go to PerigonMed now and let’s streamline the management of your revenues.
