Providing outstanding medical services is at the very heart of your mission and vision.  However, actually treating patients is just one part of running a new medical practice. The rest is business “stuff” that takes up a lot of time, and can quite frankly be confusing. Optimizing your RCM (revenue cycle management) ensures that your submitted claims get paid and patients can continue to get the care that they need.

There are many issues that come up regarding the monetary side of running a new healthcare practice. Here we want to take a look at what issues can pop up and how revenue cycle management solutions can create a more streamlined business for you.

Problems with Medical Billing and Revenue Cycle Management

Medical billing and coding is just one part of the overall RCM process. But it’s a big area where many practices end up running into problems that ultimately cost money. Those money issues are nothing to laugh at either. A recent study shows that unpaid bills are into multiple millions of dollars, and many CEOs and other executives are at a loss at how to recoup that money.

So where are the potential pitfalls?  How do millions of dollars never get collected?  Here are the most common problems with a new healthcare practice RCM.

Medical Billing and Coding – The biggest priority in being paid for the services you provide is sending out the bills on time. Coding and billing can take up a lot of time, and may end up being more than just one person can handle. Two or more staff can easily be required in order to have all coding and billing done correctly the first time, but that means higher overhead in employee costs. When claims aren’t coded and submitted correctly, they are denied by the insurance company and must be corrected and submitted again. These errors can be avoided with more attention to detail; however, when someone is doing this in-house, efficiency is everything. The faster claims are submitted, the more often errors will happen.

Claims Denial Management – When a claim is denied by an insurance company, there are methods of recourse available.  But every time it happens it takes up more of your staff’s time, and it ends up delaying the payment that you are counting on to keep everything running smoothly.

Insurance Verification – Even procedures and treatments that are coded and billed correctly can be denied when the patient isn’t covered for that procedure. In order to optimize the revenue cycle, verifying insurance beforehand is essential.

Patient Collections and Follow-Up – When insurance won’t cover a claim, paying a medical bill becomes a low priority for many patients. Without consistent efforts in-house or from a 3rd party to collect on the bill, a significant portion of your services go unpaid.

Outsource to optimize your RCM

Running a practice that is paid on time is the only way to continue to provide the best care possible. When multiple staff members are spending the majority of their time reviewing and resubmitting denied claims, payments can take months to come in. That delay can seriously hurt your new medical practice.

Optimizing your RCM with outsourcing helps to streamline the payment process, and ultimately helps to grow your medical practice. Doing all medical billing and coding in-house can cost a lot of money that could be put to better use improving your facility to handle more patients more efficiently.  Relying on Advantum Health to take care of this process for you means that you have less overhead, fewer worries about delayed payments, and fewer denials.

Finding the optimal revenue cycle management solution doesn’t have to be difficult. While these things can all be handled in house, you can save on overhead and get reimbursed faster when they are outsourced to Advantum. We specialize in making sure that you get the payment you deserve on time.

When it comes down to it, optimizing your RCM can be done by our experts so that you can focus on why you run the practice in the first place: taking care of patients and providing the best care possible.

Creating optimized revenue cycle management solutions is our specialty. Contact us to learn how we can optimize your RCM.