Learn the role of Business Process Outsourcing (BPO) partners in revenue cycle management (RCM) and how Southwest Recovery Services helps health care providers.
Effective RCM Financial Services From Southwest Recovery
From a patient’s perspective, their relationship with a medical provider starts with the appointment and ends when they leave or when they pay their final bill. However, a provider has a continuing relationship with the patient that may not end for months afterward. This is because of the revenue cycle, or the process of managing patient accounts and receivables.
Insurance filings, appeals, patient co-pays, deductibles and the management of this process are labor-intensive and time-consuming. You can optimize your practice’s revenue cycles by partnering with a Financial Business Process Outsourcing provider like Southwest Recovery Services. When you outsource your RCM services, our dedicated and experienced team reviews each patient account to ensure your practice gets the financial compensation you are entitled to.
Revenue Cycle Management Overview
For health care practices to provide the highest-quality care for patients, they must maintain financial viability. Revenue cycle management ensures providers are paid correctly and on time for the essential services they offer. Whether your in-house staff or a third-party RCM provider handles the responsibilities, some of the most common tasks associated with revenue cycle management include:
Gathering patient information
Verifying insurance
Medical coding
Submitting claims
Billing patients
Documenting payments received from patients, insurers and other payers
Following up on outstanding balances
Resolving claim denials
Filing appeals
These tasks contribute to a health care practice’s stability and financial viability. When RCM is successful, it provides various financial and operational benefits by streamlining the billing process, ensuring proper payment and providing patients with a positive treatment experience.
Challenges in Revenue Cycle Management
Competent and friendly staff are the backbone of any great medical practice. These professionals are a patient’s first encounter with your practice — and their dealings with your team leave a lasting impression on their overall patient experience.
Often, the team members handling revenue cycle management are the same people responsible for dealing directly with the patients. From managing financial responsibilities and setting the appointments to handling the paperwork and medical history forms, your staff may be juggling too many responsibilities to handle your RCM properly.
Placing a lot of extra tasks on the staff contributes to mistakes, chances of increased stress in the practice and frustrated patients.
If you’re still handling your health care organization’s revenue cycle management in-house, here are some of the challenges you undoubtedly face:
Inaccuracies: The number one reason for insurance claims denials is inaccuracy and errors in paperwork. Something as simple as an incorrect ICD-10 code or missing signature can result in a denied claim. In this case, the need to file an appeal will be necessary, which delays reimbursement and potentially an incorrect bill to the patient.
Regulatory compliance: Staying compliant with changing health care regulations and coding requirements is a constant challenge. When not managed appropriately, this can lead to costly errors.
Technology demands: Optimized RCM relies on a solid technology infrastructure. Your practice may not have the budget to invest in the latest billing software and systems.
Diverted resources: In-house RCM requires significant time and attention, which can divert your staff from core patient care activities and overwhelm your team.
Optimize Your Financial Processes With Outsourced RCM Solutions
One of the best ways to avoid some of these pitfalls is to outsource parts of your revenue cycle management to a reputable and competent third-party provider like Southwest Recovery Services. Our advisors offer specialized RCM services and solutions to equip your practice to handle administrative tasks related to medical billing and claims more efficiently.
Efficiency is the key to maximizing revenue and boosting profit. A recent Black Book RCM vendor client experience poll found that over 70% of hospital CFOs determined RCM outsourcing to be the best solution model for efficient revenue management. Larger group medical practices share a similar opinion, with more than 10% of professionals preferring to outsource tasks related to the processing of claims and management of collections.
Financial BPO providers like Southwest Recovery Services are uniquely positioned to assist health care organizations that wish to improve their revenue cycle performance.
The Role of Partners in Revenue Cycle Management
A revenue cycle management partnership is a collaboration with a third-party RCM provider. These companies work with health care organizations to optimize their financial processes and improve revenue generation. A BPO provider, like Southwest Recovery, specializes in all the duties your in-house team provides, including medical billing, coding, claims processing and managing your accounts receivable.
Along with these fundamental RCM tasks, our experienced team has specialized industry expertise, which allows us to facilitate your RCM procedures and improve your organization’s financial health.
Streamlined Administration
Dozens of individual administrative tasks go into managing patient accounts and receivables. From coding separate procedures to processing claims, these essential yet time-consuming tasks are necessary for accurate and timely reimbursements. Our agents can handle these responsibilities more efficiently, as they specialize in error reduction and accelerating the revenue cycle.
Regulatory Compliance
Compliance is crucial in the health care industry. Outsourced providers like the team at Southwest Recovery Services are well-versed in the most up-to-date coding standards and regulatory requirements, including HIPAA standards. This expertise ensures your RCM maintains complete compliance and avoids costly penalties.
Automated Claims Processing Functions
The faster a claim is processed, the more quickly your health care organization can access that cash flow. Third-party RCM providers utilize the latest technology and streamlined workflows to expedite the claims process. At Southwest Recovery, our automated systems can be used to:
Verify insurance eligibility
Submit claims
Track claims status
These features accelerate the revenue cycle, reducing the time it takes for our clients to receive payments.
Health Care Revenue Cycle Analytics
An RCM outsourcing company can leverage data analysis to optimize a health care provider’s revenue cycle. Revenue cycle analytics are tools and techniques that provide valuable insight into a health care organization’s revenue cycle operations, such as billing, collections, claim processing and reimbursements.
Data-driven insights powered by the latest technological tools allow Southwest Recovery to help your practice make informed decisions about your RCM strategies — and ultimately improve your bottom line.
When you decide to outsource your RCM, you need a trusted partner. Southwest Recovery Services has been providing superior services to the medical industry for 20 years.
We understand that RCM is not a typical debt collection. Our dedicated RCM teams are experienced and tenured in all aspects of medical transcription, billing, insurance, appeals and when necessary, patient collections. Our services function as an extension of your practice by providing accurate and updated information on charge captures, submission of claims, processing and remittances and other related administrative tasks.
Let Southwest Recovery Services contribute to a more efficient and effective revenue cycle for your health care organization. We will navigate the complex financial landscape of coding and compliance so that your staff can focus on providing outstanding patient care. If you’re ready to achieve better financial stability and sustained growth, contact us today to learn more about how we can help!
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