5 Reasons To Upgrade Your RCM System

The reimbursement system in the healthcare industry is very complicated. With federal and state regulations and third-party payers-each having their own set of adjustments and rules – eye care practices are challenged at every turn. Now add to these struggles the challenges related to claims denials, appeals, and lost revenue.

One thing that can save eye care practices from this financial mayhem is an effective RCM system.

So, if you think your practice is losing revenue, maybe its time to upgrade your RCM system. We understand change can be intimidating. Providers often overlook the shortcomings of their existing RCM system when faced with the realities of extra cost, training staff on new systems, and losing productivity.

However, when your practice’s financial health is on the line, it’s wiser to look at the downsides of settling for an ineffective system. Because one thing is for sure, once you upgrade and start using new features to fix billing errors, you will see your revenue increasing.

Reasons For RCM System Upgrade

Upgrading or switching the RCM system doesn’t have to be a negative experience. The right vendor will make the transition smooth, and the added productivity that comes from new features will make all the hassle worth it. Here are some more reasons and associated benefits of an RCM system upgrade:

  1. Streamlined Processes: The RCM system can simplify and automate every stage of your billing process. The valuable patient data can be used to reduce claim denial rates, streamline processes, enhance employee efficiency, and ultimately boost your practice’s bottom line. Some RCM systems are designed for your specialty, which means they can better align with your practice’s workflows and improve patient experiences and medical outcomes.
  2. Improved Financial Health: The in-depth and easy-to-understand data provided byRCM systems can act as an essential antidote to chaos and help you understand and track your practice’s financial health. The information is necessary for your practice’s growth and survival. For instance, by organizing the claim denial process and reducing A/R days, a modern RCM system will reduce your practice’s bad debt and, eventually, increase revenue.
  3. Reduced Claim Denial Rates: Claim denials are the most common barrier to an effective RCM process. According to a report, Healthcare practitioners lose thousands of dollars per month in ‘unclean’ claims.An effective RCM system will reduce claim denial rates by streamlining your front-end operation and reducing your billing error rate, thereby bringing down the denial rate. Most of the denials are due to billing errors, coding errors, and incorrect discharge status. An updated RCM system will identify and fix human errors before inaccurate claims are filed.
  4. Reduced Costs: By implementing a user-friendly and updated RCM system, you will be able to retain employees, reduce staff turnover, bring down overhead costs, and boost practitioner performance. The automation of billing tasks will also help you bring down costs. The visualization tools in an RCM system will allow you to mitigate performance issues and augment KPIs.
  5. A New Partner to Accelerate Your Growth: When you choose to upgrade your RCM system by switching vendors, look for a vendor that can grow with your practice. Ask for customer testimonials and case studies on eye care practices similar to yours or larger than yours. If you plan to grow your practice, your needs will evolve. Don’t just select a vendor based on your present needs; find a vendor who has the potential to accommodate your expected growth and can add features to the product as you need them.


Not all vendors may offer the features and capabilities you need to make substantial changes in the existing RCM system. If this is the situation, don’t shy away from switching RCM vendors. But be careful in selecting the new vendor and make sure you ask relevant questions to determine their expertise before committing. Embracing a robust and modern RCM system can streamline your billing processes and improve your practice’s financial health. The only prerequisite is that you have to be proactive when it comes to managing your revenue cycle.

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