RCM: The Ultimate Guide to Improving Practice Fiscal Health
Enhancing your practice's financial health starts with optimizing Revenue Cycle Management (RCM). By focusing on both the front-end and back-end processes, you can streamline payments, reduce delays, and boost your bottom line. Here’s how to improve your RCM and, in turn, your practice’s financial well-being.
1. Improve Upfront Collections
RCM can be divided into two stages: front-end and back-end. The front end is where you have the most control—this is where patient interactions happen, and timely payments can be influenced. The back-end processes, like insurance reimbursements and patient balances, are more challenging to control as they depend on third parties.
To maintain timely payments, focus on upfront collections. Providing patients with payment estimates and offering flexible payment plans can help reduce revenue gaps caused by delayed payments.
2. File Claims Promptly
Timely claims submission is crucial for staying on top of your RCM. While Medicare may allow up to a year to file a claim, many private insurers have much shorter deadlines—usually around 90 days. Missing these deadlines could mean writing off claims and losing out on valuable revenue.
Filing claims as soon as possible not only ensures you meet deadlines but also shortens the time it takes to receive payment.
3. Modernize Your Claims Process
Denied or rejected claims can significantly impact your practice’s cash flow. By investing in AI-powered RCM technology, you can submit cleaner claims, reduce errors, and maintain a steady flow of income.
Many RCM solutions offer automated workflows that flag coding issues and scrub claims before submission, ensuring they meet specific payer criteria. This automation saves your staff time and allows them to focus on patient care and other tasks that contribute to your practice’s growth and reputation.
4. Define and Track Key RCM KPIs
Monitoring key performance indicators (KPIs) related to your revenue cycle is essential for maintaining financial health. KPIs help you track important metrics like cash flow, identify potential problems, and highlight opportunities for improvement.
Some of the most important RCM KPIs to track include:
- Accounts receivable (A/R)
- Charge lag
- Cash collections
- Denial rate
- Rejection rate
By regularly reviewing these KPIs, you can make data-driven decisions to improve your RCM processes.
Download our free RCM KPI guide to learn more about how to benchmark your practice’s performance against industry standards.
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