Whatever is the billing system followed or expertise working on revenue cycle management everything boils down to the AR days. Is the AR graph looks dipping down as the AR days goes further, this is very good result and a healthy revenue cycle graph. Or its looks flat line or sinusoidal and inconsistent, this very unhealthy sign and needs immediate diagnoses. Outstanding revenues and an unsystematic revenue cycle are two major factors that can bring down the efficiency and cash flow of any healthcare service providers. As a healthcare service provider, you need to be more concern about the RCM as equally with patient service. By some estimates, hospitals are losing 3 percent to 5 percent of their net revenue from inadequate revenue cycle management. It is not just losing your money, itâ€™s your valuable service rendered which is not getting due credit because of lacking in handling the revenue management. It becomes highly essential to have an aggressive revenue cycle management team.
Revenue cycle management solutions from BOSS
BOSS guarantees you quality services returns to your decision by joining our revenue cycle management program. We can manage the entire revenue cycle starting from a verifying of patientâ€™s coverage, admission to the hospital, treatment and discharge to post discharge claims and accounts settling.
BOSS Experience in revenue cycle management
BOSS has 25 years of combined experience in RCM; we have handled multi specialty billing cycles and have hand on work experience in all departments of RCM. Here is a brief overview of how we approach on revenue cycle management:
The coding process includes the following steps:
- Insurance verification on coverage and benefits
- Patient appointment scheduling
- Clinical documentation
- Medical transcription and coding, patient health information entry and management
- Charge capture and claims entry
- Medical billing
- Payment posting and denial management
- Constant follow up for outstanding payments/accounts receivable
- Review of reasons for non-payment and corrective measures adopted for better revenue realization
- Patient accounts management
- Patient answering systems
Why choose BOSS for healthcare revenue cycle management?
By partnering with our outsource program you have benefits of complete outsource satisfaction
- You save almost 60% on your operating costs
- Around the clock 24X7 services support ensuring quick turnaround time
- Experienced personnel will handle your revenue cycle management
- Dedicated team for each client
- Guaranteed business continuity management
- Aggressive follow up of your bills and records for better revenue collection
- HIPAA and OIG compliant proven processes for high performance revenue cycles
- Risk free outsourcing ensuring data security policies
Partner with BOSS for highly efficient revenue cycle management
What you need is a strong outsourcing partner who can help you face the challenges posed by the healthcare industry. BOSS has a proven track record of successful projects and a happy clientele across the world. You can bank on BOSSâ€™s experience, especially our proficiency in handling healthcare revenue cycle services. We assure you a successful and profitable outsourcing engagement with us.
By outsourcing RCM to BOSS, how does it help you?
- Accelerated and streamlined cash flow
- Systematic and structured operations
- Faster revenue realization
- Constant monitoring of key revenue cycles
By stepping on advantages of our strong technical knowledge on billing and collection blended with industry experience enable us to be a preferred outsource partner apart from our quality deliverables and cost saving module program which empowers our clients. Moreover, outsourcing becomes wise business move for both large and small practice management groups for cost effectiveness, high quality work and relief from the hassles of staff management
Before you decide to outsource always consider two main factors that can influence your outsourcing strategies experience and knowledge which is richly available with BOSS. We want you to be confident about our capabilities, you can do this by signing up for our Free Trial Offer which comes with no obligation or set up fee. Based on the free trial, you can evaluate our work and then we are sure that you will not want to miss leveraging our healthcare revenue cycle services.
BOSS Knowledge in revenue cycle steps
Co-ordination between back-end and front end: Working EDI rejection reports, appealing denials, or processing credit balances, calling insurance for correction information are all examples of rework. Although effective back-end clean-up work can get some types of claims paid but these processes occur often late for many of the common sighted errors such as wrong, expired, or incomplete insurance information; no prior authorization obtained; non-covered service by patient plan; applied to deductible, no proper insurance follow-ups or failure to send notification. To minimize rework, it is important to develop an effective front end and back end work process that is focused on getting all of the information required for correct and complete billing. Actions should include verifying insurance coverage and benefits information prior to the scheduling an appointment, ensuring prior authorization obtained for the right service at right time, and making sure the patient’s billing information is up to date. As these processes become embedded in the organization and performing such tasks thoroughly on the front end is very essential and well supported by back end, often requires additional staffs.
Confirming payment prior to service: With bad outstanding AR and constantly rise of increasing complex payer models, it is very important to confirm payment prior to service. This process looks simple but it requires multiple steps and is best done with dedicated front end staff and well co-ordinate from back end. To confirm payment prior to service, the first step is to verify that the patient coverage and benefits. For most major payers, verification can be accomplished online or via the telephone which is more preferable because certain detailed coverage info may not be enlisted online e.g. how many visits already used up/ certain procedures are covered benefits or not. The next step is to confirm whether that the service scheduled requires prior authorization or not, because some payers may require prior approval from them before the services rendered. Typically, the physician must supply the payer with the clinical information required for authorization and it is appropriate for front end staff to be responsible for making sure the authorization is received and that it is for the correct date and service. Confirming payment prior to service is important for collecting revenue from not only insured patients, also from self-pay, workman compensation and PIP.
Standardization of procedures followed: In our own experience we have seen many organizations do not follow standardized procedures for recording errors, posting denials and write offs. E.g. having denial code in master and using financial code to post for deductible. It is difficult to develop a clear picture of revenue cycle issues because the data are inconsistent. In many cases, the information that is available has a large element of human error and manipulation data for short period. E.g., new office staff posting denials, payments, and write-offs may not be using standard definitions to describe the reason for the denial or write-off or may not know the clients specification followed. In severe cases, staff may be posting denials and zero payments as “contractual adjustments,” which automatically removes the hospital’s ability to identify, rework, and resubmit the claim. Lack of standardization and inconsistency in use of definitions causes the data that are available to misrepresent what is actually occurring, making it virtually impossible to identify drivers of variation and lost revenue. The first step is to obtain valid data, determine the course of action and directed specifications. This would eliminate factors that may cause a denial, write-off, or partial payment. The next step is to categorize these factors into a limited number of similar groups and give them a descriptive title. Last step, once the all procedures are standardized with floating payer rules, all front end and back end personnel need to be trained on the standard definitions and how to apply them. A manager or supervisor should regularly audit charts to ensure the codes are used consistently. By taking these steps, an organization can begin to see performance trends and ensure greater accuracy in financial statements.