Why is revenue cycle management important in healthcare?

July 21, 2022

RCM is a vital set of billing processes that a practice follows to receive quick and adequate reimbursements for their services. Without a solid revenue cycle management strategy, practices can experience lagging reimbursements, increased insurance claim denials, and ultimately lost revenue.

In this article, we’ll cover: 
  • Why is Revenue Cycle Management Important?
  • Outsourced or In-House Revenue Cycle Management: Which is Better?
  • Ways to Boost Your Practice’s RCM with Benchmark Systems.

New to RCM? Learn the basics.

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Why is revenue cycle management important in healthcare?

Healthcare organizations rely on efficient revenue cycle management strategies to maintain profitability. Providers perform crucial services every day and deserve to get paid for their time–but it’s not always easy to collect and process payments from patients. Even the smallest errors can result in substantial financial setbacks which is why RCM services are so important. Here are some specific ways that revenue cycle management optimizes medical practice cash flow: 

Improved Insurance Claims Approvals

Effective revenue cycle management experts prioritize accuracy on front-end tasks so medical bills and insurance claims are correctly coded and filed to the patient’s insurance provider. Insurance claims are sometimes denied due to incorrect medical coding, missing chart information, or a lack of prior authorizations. In these cases, medical practices can correct and refile denied claims, but that slows the payment process significantly. 

According to the U.S. Census Bureau, one in five patients in America can’t afford their medical bills. That means practices that don’t receive reimbursement through insurance may never get paid for their services. Filing claims to insurance organizations is absolutely essential to ensuring the patient owes the lowest out-of-pocket cost.

Faster Reimbursement

Unlike other monetary exchanges, healthcare charges are extremely complex with lots of moving parts. If medical practices don’t have revenue cycle management processes in place, lags in payment can occur. One small error or even a missed follow-up can lead to massive delays. When a practice’s revenue cycle management is working well, there is roughly a 30-day window from service to payment.

Enhanced patient experience, healthier populations

Some patients avoid seeking healthcare altogether because of the fear of “hidden fees.” If a provider performs a procedure or prescribes a medication that insurance won’t cover, then the paying responsibility falls to the patient. These unexpected out-of-pocket expenses hinder a patient’s livelihood and may discourage them from seeking further necessary care. 

Revenue cycle management prevents patients from receiving surprise bills and improves transparency among patients and providers. 

Reduced administrative burdens

Medical practice management systems help simplify and accelerate essential administrative tasks, such as patient onboarding, scheduling, prior authorizations, insurance verification, and billing. Outsourced revenue cycle management teams take the burden off in-house teams to perform some of these tasks, particularly processing claims. 

Overall improved bottom line

Medical practices that have healthy revenue cycle management can proactively assess their profits and losses to ensure that expenses aren’t outpacing revenue. Financially stable practices can invest in their facilities, instrumentation, and personnel to reduce staff burnout and improve patient outcomes. They’re able to pay competitive wages to attract and retain top talent, reducing costs associated with a high staff turnover rate.

In-house or outsourced revenue cycle management: Which is better?

Outsourcing RCM prevents medical practices from hiring full-time, expensive medical billing and revenue cycle management experts, and can significantly reduce AR while improving clean claims rates. Healthcare organizations of all sizes–including large hospital systems–partner with revenue cycle management providers to reduce overhead costs and improve cash flow.

Ready to prioritize your medical practice’s RCM?

With Benchmark RCM, clients reduce their AR to an average of under 30 days, and minimize error rates, resulting in a 98% Clean Claims Rate. 

 

Benchmark RCM specialists are experienced and dedicated revenue cycle management experts. Our team can handle account and denial management, data entry, reviewing codes, and minimizing errors so medical practices get paid faster and improve overall profitability. Benchmark System’s Integrated Clearinghouse makes processing claims more efficient and streamlined.

Benchmark RCM clients improve collections by an average of 10 – 15% in their first year.

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