How to Fix Rejections to Improve Revenue Cycle Management in Healthcare

The Revenue Cycle Management (RCM) process provides value to healthcare providers by ensuring that the entire encounter with a patient is effectively managed, from initial inquiry through final payment. This implies that accurate information is gathered and documented, patients are only billed for services rendered, third-party payers are contacted on time, and payments are collected.

At its core, the revenue cycle is a complex commercial relationship with patients with several touchpoints. Mismanagement of these operations can reduce patient and clinical satisfaction and harm the organization's reputation through unnecessary denials and bad debt.

Failure to appropriately prioritize RCM and revenue collection initiatives, regardless of the size of a practice, hospital, or health system, can stall growth, increase operational risk, and create an unclear financial future.

3 Ways to Fix Rejections To Improve Revenue Cycle Management in Healthcare

1) Automate Patient Eligibility Verification 

Automation is key to increasing productivity in your organization and patient eligibility is an activity that can be automated by an AI solution. Verifying patients are eligible for treatment ahead of time can reduce claims rejections and eliminate a key pain point in your billing process.  

Automating tedious and repetitive office tasks give the staff more time to focus their attention on tasks that require a human touch which can improve patient satisfaction and improve staff morale. 

2) Verify Payment Processes Up Front 

When a patient schedules an appointment, the staff gathers current information to verify insurance eligibility and payment method. You may also have a portal available for patients to enter their information which will allow patients to make their payment. Transparency for what a patient owes and multiple methods for patients to pay will provide greater success at obtaining payment up front. Generally, the simpler and more accessible your payment method is, the better your patients will respond.  

3) Outsource Medical Billing 

Another option for your medical billing is to outsource it. Many healthcare providers can improve their revenue cycle management by outsourcing to billing experts who are incented to capture more charges & manage rejections which results in the provider being paid faster.  

Are you looking for experts who can help you fix rejections to improve revenue cycle management in healthcare? Request a discussion today with tevixMD.