What Are the Most Common Mistakes in Revenue Cycle Management?

The revenue cycle management processis essential to control all the financial aspects of a medical business. This process helps healthcare providers track and maximize their revenues. It also needs to be carried out in a sequential manner since any form of errors can disrupt the smooth flow of this process. Therefore, it is necessary to be aware of the various mistakes that can cause financial losses and try to prevent them. Some of themost common mistakes that occur in the RCM process include:

Revenue Cycle Management

· Haphazard Billing Process

 Situations likean upsurge in the number of patients will cause an increase in the number of medical claims. When the RCM process is not well-defined, these fluctuations would not be handled effectively. Standardizing the healthcare revenue cycle process can help define the process to ensure billing efficiency.

· Poor Follow-up on Medical Claims

It is essential to follow-up with patients to complete payment collections. Various strategies are used to ensure collections such as offering payment plans, sending out collection letters, etc. These strategies can become useless if the follow-up process is not carried out. Thus, following up with patients is necessary to ensure complete reimbursements.

· Failing to Resubmit Claims

Claims denials occur because of errors such as coding issues, lack of credible patient data, etc. These errors must be resolved immediately by making necessary adjustments to the claim. The claim must then be resubmitted to the insurance payer. Failing to re-file the claim on time causes healthcare practices to lose their revenue.

· Not Verifying Patient Eligibility

Patient data must be updated every time a patient visits the healthcare provider. This is important to avoidinaccurate entry of patient information and errors in insurance coverage. Verifying patient eligibility reduces the chances that medical services are provided without the required insurance coverage.

· Making Coding Errors

Medical coding is an essential step in the healthcare revenue cycle process since medical codes make up a major part of medical bills. Errors in these universal medical codes can cause the claim to be rejected. To avoid coding errors, medical coding staff must maintain coding accuracy by keeping their ICD coding knowledge up-to-date.

· Insufficient Staff Training

Training RCM staff is required to ensure a smooth billing process. Staff need to be trained to keep themselves updated about any changes in the revenue cycle management processespecially pertaining to HIPAA regulations, etc. Any changes in the process must be noted and implemented to increase billing efficiency.

The efficiency of revenue cycle management can be rapidly increased by avoiding these common mistakes. Most healthcare practices choose to outsource their RCM needs to renowned revenue cycle management companies to improve billing accuracy. In this way, they can avoid common billing mistakes resulting in complete reimbursements for their medical practice.

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Article Author Details

Sahil Arora