Providing treatment and saving lives is just the tip of the iceberg for the healthcare ecosystem. While hospitals, private practices, and specialty facilities are essential as the physical location where visits and check-ups happen, they also need to be financially healthy in order to continue providing these services. As a result, the importance of revenue cycle management cannot be understated.
Revenue cycle management refers to the financial processes and transactions involved in the management of funds and collection of payments related to services rendered between a patient and a provider, facility, or supplier. Without these processes, healthcare organizations and facilities would not be able to stay open to the public for care. Given the alternative, it’s no wonder that retaining reputable healthcare revenue cycle management companies is a top priority for those managing the business side of a healthcare organization. The best revenue cycle management companies not only keep the lights on, but they also know how to increase revenue for the business.
Finding success in revenue cycle management in medical billing requires understanding the process from start (when a patient makes an appointment for medical services) to finish (when all claims have been made and payments are collected). Before the patient even comes in for a visit, it’s important for the administrative staff to begin pre-authorization to determine whether or not the medication, procedure, or service is medically necessary. Afterwards, it must be determined if the patient is even eligible for benefits. After the patient is seen, the provider submits a claim that details the treatment and services received using medical codes that signify how much should be covered and reimbursed to the physician or facility.
After insurance companies evaluate a claim, they typically reimburse the organization for the services rendered pending the patient’s coverage. However, there are cases where claims are denied because of incomplete patient records, missing information, or incorrect coding. Successful healthcare revenue cycle management quickly gets the organization paid in full for the services provided, though this isn’t always the case. When claims are processed for months because of issues between payers and providers or a patient’s inability to pay the bill on time, there is a significant lag in payments received.
Hospital revenue cycle management companies are in high demand because the survival of the organization depends on a strong revenue cycle. So stop searching for ‘revenue cycle management companies near me.’ MRA is among the top revenue cycle management medical billing companies in the nation and can manage the revenue cycle for your business, regardless of size (from private practice to public institution).