Revenue cycle management (RCM) encompasses the processes that a healthcare provider uses to track the reimbursement for patient care provided from the scheduling of a visit (or arrival of the patient, in a non-scheduled setting) to the final bill payment. Without sufficient revenue and a highly capable and efficient RCM process, hospitals and medical practices don’t have the resources they need to support and treat patients. RCM includes:
- Collection of patient demographic and insurance information.
- Verifying insurance eligibility and authorization for treatment.
- Providing patient estimates.
- Charge Capture.
- Utilization Management.
- Claims scrubbing and submission.
- Payment collections and follow-up.
While providers can choose to handle all of these functions internally, outsourced revenue cycle management has become increasingly common. Some of the advantages of outsourced Revenue Cycle Management include:
1. Providers Can Focus on Their Patients
Understandably, most physicians didn’t enter the medical field to focus on billing – they did it because they want to help people. By outsourcing RCM to a qualified service provider, physicians can spend more time focusing on providing high-quality care. And when healthcare providers turn over billing and claims management to an expert, they’re also helping ensure that each patient has the best and highest quality experience possible from the moment they walk in the door.
2. Administrators Spend Less Time on Training and Compliance
The healthcare industry is always changing and advancing. That’s great news for patient care, but it can pose a challenge for providers and administrative staff, who need to constantly keep up with new software, corrections to billing codes, changes in payer contracts and complicated updates to government regulations. With a qualified service provider handling your patient billing and collections processes, your practice won’t need to expend as much time to developing resources to train (and retrain) your staff.
3. Outsourcing RCM Reduces Billing Errors
A single billing error can add hours of administrative follow-up time and cause lost revenue. Because there are changes and updates to medical billing codes and regulations each year, it can be difficult for in-house staff to maintain efficiency while capturing charges and coding precisely and accurately. Outsourced revenue cycle management turns over coding functions to a qualified vendor, which means your team will have fewer errors throughout the billing and coding process and can avoid billing resubmissions and claims denials.
4. Outsourced RCM Means Reduced Time to Payment
The healthcare reimbursement process can take weeks or even months. This can create significant challenges for healthcare providers who are trying to manage shrinking margins while at the same time providing excellent care and retaining qualified staff. With a dedicated partner, you can turn over the ongoing monitoring that revenue cycle management requires, ensuring more predictable financial performance. You can be confident that you’re getting the maximum reimbursement in a timely manner – which allows you to increase profits and better serve your patients and staff.
Choose Ventra Health for Expert Outsourced Revenue Cycle Management
If your hospital or practice is looking for an experienced partner for outsourced revenue cycle management, Ventra Health is here to assist you. Our team provides advisory solutions to more than 400 clients across the United States, serving to optimize their operations, boost revenue, and reduce billing errors. For more information about Ventra Health’s managed services, contact us today.