Outsourcing can Help Overcoming Revenue Cycle Hurdles

1
Outsourcing can Help Overcoming Revenue Cycle
Hurdles
2
Outsourcing can Help Overcoming Revenue Cycle
Hurdles
Healthcare revenue cycle challenges exist at
every stage of practice management, beginning
with appointment scheduling and extending all the
way through claims, billing, payment, and
collections. Technology, regulations, changing
contractual obligations and payer policies,
people, processes, billing each of these
complexities add to the challenge. These Revenue
cycle management (RCM) hurdles lead to revenue
loss ultimately challenging the day-to-day
activities of practice management. In this
article, we will discuss how outsourcing can help
overcoming revenue cycle hurdles. Overcoming
Revenue Cycle Hurdles Consistent Denials Claim
denials are an obvious step in medical billing.
As per industry standards, efficient medical
billing can receive up to 5 percent of claim
denials. Whats not acceptable is receiving claim
denials for the same procedure codes again and
again and not trying to find reasons behind it.
Poor revenue cycle activities could lead to high
denial rates, sometimes even 30 percent of
submitted claims. Practices might face such a
high denial rate due to the absence of a skilled
billing team. Sometimes practice owners try to do
everything on their own and even submit claims
without a detailed understanding of billing
guidelines. Practice owners cant dedicate much
time to denial resolution activities due to their
commitment to patient care. When you outsource
your billing and coding activities to the medical
billing company, they have experts who analyze
the denial reasons.
3
Outsourcing can Help Overcoming Revenue Cycle
Hurdles
The billing company has experienced billers and
coders who are well-versed in payer and medical
specialty-related billing guidelines. Such an
experienced denial resolution team from the
billing company ensures that you have a
resolution for every denial reason and appeal the
claims on a timely basis. Medical billing and
coding being core expertise, billing companies
help practices to reduce denial rates drastically
bringing them within industry standards. Poor
Collection Rates Whether its insurance
collections or patient collections, healthcare
practices often struggle to collect payments.
Its always easier to collect payments on the
first attempt. Payment follow-ups add
comprehensive costs due to the time invested by
your team. Its easy to manage day-to-day
practice management activities with timely
collection of payments. Nowadays, as more
patients are adopting high-deductible health
plans, patient responsibility has increased
exponentially. Medical billing companies can
assist you in the timely collection of insurance
and patient payments. The billing company take
frequent follow-up on submitted claims and ensure
that any denied or rejected claims get appealed
quickly. Due to various practice management
activities, providers cant take active
follow-ups on claim status. Medical billing
company like Legion Healthcare Solutions shares
insurance coverage report for every single
patient visit, a few days prior patient visit.
This helps identify patient financial
responsibilities like co-pays, co-insurance, and
unpaid deductibles. With such a detailed
insurance coverage report, you can collect
patient payments at the time of the visit only.
4
Outsourcing can Help Overcoming Revenue Cycle
Hurdles
Billing Errors Medical billing and coding is a
different specialization and most of healthcare
providers havent taken any official training or
certification for it. Providers trying to manage
billing and coding all by themselves end up using
a bunch of procedure codes to bill all their
patient visits. Such billing practices could lead
to the use of inaccurate CPT codes/ modifiers
bundling/un-bundling of codes up-coding or many
other billing inaccuracies. Such inaccurate
billing practices for a long time could attract
external payer audits. When you outsource to
Legion Healthcare Solutions, your billing and
coding activities are taken care of by
specialty-wise billers and coders. Our
well-trained and experienced billers and coders
ensure that every single claim is audited
properly before its submission to the payer. We
constantly share various billing reports which
help practices to understand key areas like the
number of submitted claims, claim dollar amount,
practice total collection, patient
responsibilities, write-off amount, and many
other RCM parameters. Such reports are great
indications of the practices financial
performance. Legion Healthcare Solutions is a
leading medical billing company providing
complete medical billing and coding services. In
a cost-efficient way, we can assist you in
overcoming revenue cycle hurdles. To know more
about our billing and coding services and how we
can help in overcoming revenue cycle hurdles,
contact us at 727-475-1834 or email us at
info_at_legionhealthcaresolutions.com
5
(No Transcript)