How to Transition From Self-Billing to an RCM Solution
Did you know invoicing and payment processing are among healthcare’s key challenges this year? They remain a big pain point in the industry. When you combine working with insurance companies, keeping invoices organized, and billing patients directly, you get a confusing situation if you lack the right solution. Fortunately, RCM solutions can help restore order.
What Are RCM Services?
Revenue cycle management (RCM) is a business process helping healthcare organizations to get compensated for services rendered, from patient scheduling to payment reconciliation and includes some steps in between. It can be confusing without the right technology, but that’s where RCM solutions come into the picture. You’ll see the benefits of switching from a self-billing method to an RCM healthcare services method.
Many healthcare organizations are initially reluctant to outsource to a revenue cycle management services business due to medical coding and billing issues. Both need to be done correctly, so if you transition to an RCM services provider, you’ll want to ensure they have a reliable reputation.
Continue reading for a step-by-step look at how to switch to an RCM company and the benefits your healthcare organization will get from working with a qualified service provider.
How to Transition to RCM Healthcare Services
While hiring an RCM healthcare services company makes sense, how well you transition from an in-office to a third-party outsourcer setup will impact the success of the switchover. Any reputable third party in the space will provide steps for a correct transition that will minimize downtime and enable your healthcare organization to experience the benefits of RCM.
What follows is a look at some of the primary steps your health organization will need to take:
- Your healthcare organization must provide the RCM company a list of all the insurances you’re associated with.
- Your healthcare business will then need to hand over details to the authorized signer for the various insurance agencies.
- Your healthcare business must also send a list of CPT and ICD-10 codes to the RCM services company. Ask your current billing services provider for this information if required.
- Your healthcare business will also be required to send a list of CPT and ICD-10 codes to the RCM services company. Ask your current billing services provider for this information if required.
- It’s also essential that your healthcare organization give the RCM services business reports providing the following information:
- Insurance plans
- Referring MDs
- Diagnosis table
- CPT services
While your RCM services company may have some other requirements, you can ensure a successful transition by following the above steps. It won’t be long before you get to a point where you wonder why you waited so long to make the switch.
The Benefits of Using an RCM Services Company
Before deciding whether or not to switch from self-billing to an RCM healthcare services option, you’ll want to see some of the clear benefits of going this route. That’s the only way to determine whether or not making a change is worthwhile from the perspectives of cost and time. Consider the following benefits to help your healthcare organization make an informed decision:
Streamline the Process: One of the benefits of RCM is that it can streamline the revenue cycle process. Your doctors, coding specialists, and administrative staff will have access to an easy-to-use solution that cuts down on errors and helps your business be more efficient. Greater efficiency can lead to better productivity.
Improve Revenue Performance: You can also improve revenue performance since payments will be made faster, at a steadier clip, and with reduced out-of-pocket expenses. In these tough economic times, an RCM platform can be a godsend and should be a must-have.
Lower Instances of Denials: RCM solutions lower instances of denials. The right solution will facilitate accurate filings, reducing the odds of mistakes or omissions that trigger denials. Denials delay reimbursements and reduce efficiency and productivity. They also frustrate administrative staff who must put more time and effort into making changes, and they harm the patient experience.
Boost Patient Experience: When you make the coding and billing process straightforward, there’ll be a trickle-down effect that benefits patients. RCM tools focus on improving patient outcomes. Scheduling appointments, billing, and filling out intake documents are simplified with an RCM solution. What this will do is create a better patient experience. Patients will also know their insurance eligibility immediately since RCM focuses on upfront insurance verification.
Lower Administrative Burden: An RCM solution will streamline front-end duties like scheduling appointments, entering or updating patient data, and verifying patient insurance. Since procedures and processes are streamlined, your administrative staff will be able to focus on other essential duties. They won’t be bogged down by too many repetitive, manual tasks.
Better Quality of Care: Your healthcare organization can dedicate more time to improving the quality of care when you have an RCM healthcare services third party on your team. Your workers won’t have to spend an excessive amount of time and resources on fixing mistakes and appealing claims.
Simplified Processes: An RCM solutions provider will help your healthcare organization automate the revenue cycle management process, which will streamline your back-office and front-desk operations. Automation, when done strategically and intentionally, will make a difference.
Can You Afford to Forego the Benefits of RCM?
Are you satisfied with your healthcare organization’s revenue cycle strategy? If it’s not functioning effectively, it’ll adversely impact your organization’s efficiency, productivity, and cash flow. You don’t have to accept an unpredictable revenue cycle strategy.
At Horizon Healthcare RCM, we can establish order in your healthcare system. That’s one of the benefits of partnering with a premier outsourcer of revenue management solutions. Get in touch to learn more about how we can help your healthcare organization achieve the highest revenue management standard.