It does not matter the number of patients who walk into your clinic if they receive a tiny portion of their payments. It’s possible to be extremely efficient and provide excellent care; however, in nursing home billing centers financial performance, the most crucial factor to consider is the effectiveness of your revenue cycle management. What is the mean amount of days that it takes you to finish a payment cycle? How solid are your claims acceptance rates?
These are only a handful of indicators of your performance you should take into consideration when evaluating RCM effectiveness. If you’re not receiving payment, try these five suggestions to bring your A/R day to par with the industry average, or even more efficient!
Nursing Home Billing Companies
Check eligibility prior to each visit
It might sound easy enough to check eligibility prior to providing services, but nursing home billing services are able to leap through the hurdles of eligibility after the patient has visited their caregiver. This could happen due to the coverage of a patient has changed between visits from one visit to another. This could be due to changes in their nursing home billing that impact the eligibility of their insurance, or because they didn’t supply all the necessary information for a billing company to validate their eligibility.
It’s far better to gather all the information on patients and determine eligibility before you have to submit a claim after service. Nursing home billing companies your workflow doesn’t insist on this, explain the importance of confirming benefits and obtaining prior authorizations to your front-of-house team as soon as you can.
Use an automated, rule-based workflow
Think about all the payors you deal with and the various claims you make to them. Think about all the terms you deal with and the specific codes you need to use for each one. Even the best billers are likely to make errors from time to time. They could send a request to the wrong person or enter the wrong code when they submit claims to the correct payer, leading to rejections and denials.
The best method to make them work is to use an RCM platform that uses rules-based workflows such as nursing home billing organizations. When you create certain guidelines, your billers will be alerted if they’re likely making an error. The new system will notify them if the information they’ve provided is incorrect or missing. It can help billers correct any errors prior to sending out the claim, thus saving you significant time during this revenue cycle.
Streamline different revenue cycle management processes
Just one error for the whole revenue stream to suffer. Between determining the eligibility of claims, coordinating the claims process, and processing payments, there are plenty of chances for errors to occur. It is helpful to prevent and fix errors by simplifying your RCM processes using a tool like Medcare MSO Medical billing All-Payer.
Don’t think of the eligibility process, claims management, and payment processing as distinct processes. Instead, you can combine these components of your revenue cycle into one easy, simple-to-manage workflow. Make sure you have a single, efficient system to handle all claims from start to finish rather than having separate systems to verify eligibility as well as claims and payment.
This will help save a considerable amount of time and effort, as well as anxiety. This will enable billers to effortlessly move between the different stages within the process of revenue generation to others. It reduces the chance of errors and improves the rate of acceptance of claims. Sooner or later the average number of A/R days will be much less. In addition, your staff is more productive, be more engaged , and enjoy higher overall satisfaction.
Diversify patient payment options
With nursing homes, medical billing and financial responsibility comes with a greater demand for providers to diversify choices for payment. Imagine yourself in the shoes of a customer for a second. Think about how often you use your credit or debit card, utilize an application for payment, or use automated payments to transfer money. The majority of people utilize these devices when they are paying for everything from a bite at the corner shop to their car purchase. They’re expecting similar payment options when being charged for medical services.
The new system comes at a cost that is low when the long-term advantages are taken into. They’re more likely to make payments on time, and you’ll be able to handle payments more easily, too.
Resubmit all denied claims
The final method of increasing your RCM effectiveness is to ensure that every claim is paid. These tips should drastically reduce the number of claims that your team must resubmit. However, if claims are denied, it must be adjusted and resubmitted to the correct payee.
You could choose to prefer new claims over claims that have been denied. If every single unpaid dollar could add to the sum of money that you owe or could be the revenue you earn and use. Fortunately, a more efficient workflow will make it simpler to deal with claims that are denied.