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Monthly Archives: October 2014

Revenue Cycle Management – Getting Paid on Time

An effective Revenue Cycle Management helps practices to increase efficiency and revenues. It also ensures to cut cost and reduce denials considerably. Revenue Cycle Management is not about just one activity, it is all about managing the entire process from start to finish. In the healthcare setting Revenue Cycle Management begins even prior to a patient’s visit to the facility.

Pre-verification is the first step in Revenue Cycle Management. All the patients scheduled to visit the provider are verified for eligibility and benefits with their insurance. All authorization and referral requirements are clearly understood and documented. Co-pay, Deductibles and out of pocket expenses are also documented. First step to effective Revenue Cycle Management begins with collecting the patient liabilities immediately during the visit. (more…)

Business Process Outsourcing: What and Why?

Business Process Outsourcing is a method of sub contracting some parts of the operations to a third party. BPO was originally associated with manufacturing sector but later it was totally embedded as Information Technology Enabled Services. Outsourcing helps companies to stay focused on important business areas. It also helps them to use their management resources effectively. In the present situation companies face many challenges like tough economy, lack of skilled resources, lack of time to pay more attention to marketing and customer services. It has become necessary for companies to have a flexible pricing, process and technology to be successful. To sustain profitability and to access talented resources many companies go multinational to stay ahead of their competition. (more…)

Eligibility Verification is a significant denial management tool

Providers lose thousands of dollars every year when services provided by them are denied as non-covered services by the patients’ medical insurance company. Usually, the providers know about these denials anywhere between 15-30 days after the services were provided. As a result, they end up billing the patient after 30 + days and need to spend more time, money and resources to collect the dues. If they are not successful in getting the money from the patient, it will usually be moved to a collection agency. This non-productive billing process can be elevated by adopting insurance eligibility verification.

It is standard for individuals or employers to change their insurance plans for various reasons. These frequent changes make it essential for the providers to have updated information on patient insurance coverage. Hence eligibility verification process has become a crucial step in quicker reimbursement. It reduces and, in many cases, eliminates denials. Eligibility verification helps to increase provider revenues and weeds out uncollectible. (more…)