With our Revenue Cycle Management the overhead and paperwork is ours, not yours. Your revenue increases with decreased spending in these areas.
- Medical Billing Specialist salary
- Medical Billing Specialist Benefits
- Hardware Purchases / Maintenance
- Software Purchases / Renewals & Updates
- Physicians Time to Manage the Process
Until you proactively inspect your RCM, you have no way of knowing how much revenue your practice is losing.
Inspect What You Expect
Three critical areas necessary for the implementation of a scalable and reproducible Revenue Cycle Management (RCM) process:
Critical Success Factors - Claims
- Time from service provided to charge entered
- Time from charge entered to claim submitted
- Time from claim submitted to claim paid insurance company
- Percentage of claims denied on the first submission
- Detail the specific process in place to adjudicate a denied claim
- Time from receipt of denials to action taken (such as appeal, re-submission or write-off)
- Time from insurance payment to sending patient statement
- Time from first patient statement to patient payment
Critical Success Factors - Human Component
- Ask them what they do, then ask them to walk you through it. You may be surprised by what your staff is spending their time doing.
- Track non-contractual write-offs by employee, look for timely filing deadline write-offs, data entry errors and other internally generated causes for write-offs.
Critical Success Factors - Accountability
- Accounts your billers work per day, including patient accounts
- Appeals they write per month
- Denials they work per day
- Payments they cost per day
Finally, audit a minimum of 20 accounts per staff member worked during the past six months. Again, look for timeliness, accuracy and results. Pull these files randomly so that the employees cannot work them before your review.
APS Health Solutions, 117 West Main Street, Stuite 102, Lancaster, Ohio 43130, 866-653-9991 Ext. 7015
You can't manage what you don't measure.