Improve Your Medical Practice’s RCM with These Tips

Are you wondering how to improve revenue cycle management (RCM)? You’re not alone.

Managing revenue, billing, and insurance processing are crucial because your practice requires money to operate, but you might wonder if you have the expertise or time you need to attend to such matters.

Doing a few things could help you improve RCM and manage your practice’s finances.

Invest in technology

One of the most effective ways to improve your revenue cycle management (RCM) is to invest in technology.

Investments could be in hardware. Start by keeping your practice’s computers, tablets, and other electronic devices updated. For staff members who will be accessing your records and systems outside the office, pay for smartphones and other devices they could use exclusively to connect with your office. Also consider reimbursing them for software and internet fees.

Yes, hardware and internet access can be expensive. But being able to access information easily, quickly, and more safely saves time and hassle, which could ultimately save money.

Another good technological investment is software that helps you keep patient electronic health records (EHRs) and manage your practice. The best revenue cycle management software is easy to integrate into your office and easy to use by your staff.

Train and involve staff members

Involved staff members are productive (and happy) staff members.

They might not know about revenue cycle management (RCM), but that doesn’t mean they can’t learn about it.

Is your medical practice thinking about investing in electronic health records (EHRs) or practice management software? Ask for input from your employees. They may have ideas on these systems, such as which features you could implement to manage billing, track payments, and handle revenue.

For example, your employees might have noticed a pattern among people who don’t show up for appointments or ones that consistently pay their bills late. Understanding these patterns could help your staff members brainstorm for solutions to reach patients with these behaviors.

Once you’ve purchased a new EHR or practice management system, make sure your staff members know how to use it. Consider holding group meetings where employees could discuss the systems and participate in software demos (demonstrations).

If there are software updates or multiple questions about the new systems, consider holding additional meetings or tutorials. You could also designate a few employees as superusers, people who know the software well and are comfortable teaching it to and assisting others.

Improve scheduling processes

Teaching your patients about your new systems and scheduling could also help you manage revenue cycle management.

Maybe an employee you designated as your software system’s superuser could also field questions from patients who are learning how to access the clients’ part of the system. This employee could be available in-person and digitally during office hours to instruct patients and help them solve any problems.

Once your patients know how to use your electronic systems for scheduling, you could improve those processes. If they find it easier to schedule appointments, they might be more motivated to follow through and attend these appointments.

After finding it easier to schedule such appointments and work with your office in other respects, they also might be more inclined to continue visiting your practice. Satisfied patients translate into patients who continue patronizing your office. They might possibly recommend your practice to others, actions that could help you build revenue.

Verify eligibility and payment

Electronic health record (EHR) and practice management software systems could also help you improve your RCM by helping patients verify their eligibility and payment processes.

Dealing with insurance companies is a big part of the many medical practices’ work. The right software systems could make this work easier and thus more efficient and profitable.

You could use these systems to determine if insurance providers will cover particular services, and if so, how much they’ll cover. You could include information in these systems about other coverage programs patients may have, such as Medicare and Medicaid.

Since your systems store all this information and make it accessible, you, your staff members, and your patients could understand how much each type of coverage will pay. This knowledge might also help you make decisions about what to do next.

Manage claims

One of these future steps might be managing these insurance claims.

Claims are not a one-and-done type of scenario. Working with insurance companies usually involves taking multiple steps as part of an ongoing process.

Software systems, trained staff members, and informed patients could work together to manage insurance claims.

A software system could determine if a service is eligible, a patient then receives this service, and then your medical practice provides this service. But that doesn’t mean your medical practice revenue cycle management work is over.

After you’ve made an insurance claim, you need to track this claim to make sure your practice and your patient have been reimbursed. If the insurer only covered part of the claim, you’ll need to document that, possibly send additional bills to your patient, track these bills, and collect and record any payment they make.

Did the insurance company deny the claim? Is the patient questioning the claim? You need to record these developments and take additional actions, such as creating and sending appeals to the insurance company.

Working with insurance companies means communicating with them and your patients and recording these interactions. Using software systems and good communication skills could help you track these interactions and achieve satisfactory medical and financial results.

Outsource billing and other work

The above scenarios show that RCMs and insurance interactions are complicated, so you may need additional assistance.

Consider hiring outside help. There are companies that offer revenue cycle management assistance for medical practices.

During this assistance, professionals who have experience with RCM procedures assist medical practices who may not have this experience. Or, even if they have experience, practices may not have the time they need to devote to billing, insurance claims processing, revenue cycle improvement tasks, and other finance-related matters.

Your patients visit you for assistance, so there’s no shame in asking for help yourself. In fact, if you need assistance managing your revenue, your electronic health records, or other aspects of your practice, contact Eye Care Leaders. We’ll provide the assistance you need to help your practice, finances, patients, and yourself.