If your practice is verifying a patient’s insurance before a procedure, you can let them know if they need to pay a copay, or if they should expect to be billed a coinsurance. When you’re registering a patient, establish expectations with them, and keep them informed on what your staff is doing.ģ. ![]() Design a patient-oriented experience that prioritizes transparency. Ensure that if needed, it’s simple and efficient to verify the information required and receive updates as necessary.Ģ. Maintain a clear line of HIPAA-compliant communication between different individuals in your Revenue Cycle. ![]() Here are some ways to mitigate potential hurdles and ensure that your RCM is benefiting your practice as well as your patients.ġ. What if a patient’s demographic or insurance information was transcribed incorrectly, or a procedure is billed that doesn’t fit coding criteria? What happens when a claim is denied? How often is a patient left completely in the dark until the moment they get a massive bill in the mail? This is a process where there are a lot of opportunities for hiccups and stalling. Afterwards, the billing department can determine patient balances and collect payments. Submit charges of any billable patient interactions to insurance companies.Ħ. Have a coder review diagnoses and procedures.ĥ. This is what pMD has specialized in for over twenty years!Ĥ. Complete charge capture, which refers to rendering medical services into billable charges. Collect subsequent patient information during registration to establish a medical record number and meet various regulatory, financial, and clinical requirements.ģ. Before a patient arrives for inpatient or outpatient procedures, collect any pre-registration information, such as insurance coverage.Ģ. The Revenue Cycle can look a little something like this:ġ. A successful RCM process is essential for a health care practice to maintain financial viability and continue to provide quality care for its patients. Revenue Cycle Management (RCM) refers to the process of identifying, collecting, and managing the practice’s revenue from payers based on the services provided. This can begin well before a patient steps foot in the door and can continue past the final payment of a balance. ![]() The financial process health care facilities and groups use to submit claims to an insurance provider is known as your Revenue Cycle.
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