Revenue Cycle Management is business

Healthcare Revenue Cycle Management is the business aspect behind the administrative and clinical functions done by a physician. The financial process includes claims processing, payment and revenue generation. There are many steps involved in the above process, which are done by both the front and back offices.

An efficient healthcare revenue cycle results in smooth cash flow for providers. (more…)

 

5 smart ways to get your behavioral health claims paid faster!

Behavioral health professionals face unique and complex billing challenges. The nature of the patient population, the needs of the patients at various stages, and the norms for insurance coverage add to the challenges the providers face to keep the practice running.

Billing insurance companies and getting paid fairly is no easy task. Being aware of rules and regulations is vital. Here are a few ways to become adept at behavioral health services billing and get paid quickly. (more…)

Podiatry as a specialty is quite different and coding professionals need to be aware of the complexities in this specialty to reduce denial of claims. Medicare and commercial payors insist on medical necessity for foot care and thus, coding in podiatry specialty and revenue cycle management (RCM) is an area where confusion reigns. Most of the payors will reimburse if there is a foot condition but not for its preventive care. Hence podiatry coding procedures need to be dealt with carefully. (more…)

Denial Management is vital to your practice

Denial of claims is a source of stress and a drain on the revenues of a practice. Therefore, denial management is a vital component of the Revenue Cycle Management and consists of four stages, namely, Identifying, Managing, Monitoring and Preventing claim denials.

Medical professionals submit millions of claims every day to payors. Most claims are reimbursed fully by payors. As per the AMA reports, claims denied on the first submission amount to 1.38% to 5.07% of the total claims. Even the best-performing practices see a denial rate of 5%. Denied claims represent delayed or lost revenue to a practice. (more…)

What is Revenue Cycle Management?

Healthcare professionals train for years to treat patients and save lives while learning next to nothing about the business side of practices. Providers need to develop successful practice management processes to stay financially healthy. A medical facility’s entire financial process is termed Healthcare Revenue Cycle Management (RCM) and it covers management and collection of revenue from healthcare service to patients.

The healthcare revenue cycle starts when a patient makes his/her appointment to seek medical services from a healthcare provider. The process ends when claims are reimbursed and patient payments have been collected.  (more…)

What is AR Days?

Account Receivables Days or AR Days indicates the time taken to receive payment on a claim. Accounts Receivable Days is a significant indicator of the financial health of a practice. In the United States, the average AR Days is 52.46 days. The lower the figure, the better is the financial situation. A lower figure means that there is more timely payment of claims and patient bills and cash flow is steady.

Know where you stand in terms of AR Days 

Compute AR Days in the following manner 

Average Daily Charges = (total charges for last 180 days) ÷ 180

AR Days = (total accounts receivables) ÷ (Average Daily Charges)

The billing department’s performance can be assessed by pooling the accounts receivables into “aging buckets” of 0-30 days, 31-60 days, 61-90 days and 90+ days.  (more…)