Outsourcing healthcare revenue cycle management services help customize patient care according to each customer’s requirements, proven to impact the healthcare organization’s day-to-day operations while improving customer satisfaction and improving claim submissions and returns. It has helped countless healthcare practices stand up to the challenges and losses caused by Covid-19 and emerge more robust with better revenue cycle management.
The Importance of Healthcare Revenue Cycle Management
The healthcare sector has seen a significant transformation, accelerated further by the Covid-19 pandemic. Today, the healthcare industry is one of the leading industries embracing advancements in technology to deliver outstanding standards of services to the people. However, like any other industry, the healthcare industry, too, needs to function like a well-oiled machine to ensure things keep running smoothly. To make this happen, it needs effective management of finances and capital. This is where the healthcare revenue cycle management services become essential and indispensable.
What Is Healthcare Revenue Cycle Management?
Healthcare Revenue Cycle Management is the financial process of managing the administrative and clinical functions associated with claims processing, payment, and revenue generation. This includes the processes concerning identifying, managing and collecting patient service revenue. Effective healthcare revenue cycle management services ensure that the healthcare organizations keep running smoothly and efficiently while delivering the best possible quality of services to patients.
The healthcare revenue management cycle encompasses every process essential to nurturing and running a successful healthcare organization, irrespective of its size – from attracting new patients to delivering healthcare services to the patients and from billing the patients to processing insurance claims. The cycle is considered to begin when a patient makes an appointment with a healthcare organization to see a doctor and ends when the payment for the services rendered is completed. There would be multiple processes that fall under this healthcare revenue cycle which could get very complicated. This is where the need for healthcare BPO services arises.
What Are the Different Stages of Healthcare Revenue Cycle Management Services?
Challenges In Healthcare Revenue Cycle Management
The above cycle appears to be quite simple and easy. However, that is far from reality. Each stage of the healthcare revenue cycle encounters different challenges that must be overcome to ensure the cycle keeps moving ahead as smoothly as possible. There could be delays, queries, bottlenecks, approvals, errors, and so many more issues the healthcare revenue cycle runs into that it can be quite challenging to manage within the organization itself. Claims can get rejected by the insurance service providers, there could be a flurry of queries and responses between the insurance provider and the healthcare organization, which could drag into weeks, the patients may not be capable of clearing all the pending bills in one go, so they could need time to arrange the funds. There could be delays in the payment coming through even after the claim has been approved. On average, it has been found that 70% of healthcare organizations take a minimum of one month to receive the complete payment from their patients. However, the organization does not stop functioning during this time and will continue to need funds for smooth operations.
Often, the resources in the healthcare organization may have their hands full with a range of responsibilities, or they may lack adequate training to ensure effective healthcare revenue cycle management services are rendered to the organization. This could lead to expensive errors, which could cost the organization a lot more than just money. This is where the need for professional healthcare BPO services becomes valuable support and partner for the healthcare organization.
Availing professional healthcare BPO services can be immensely beneficial for a healthcare organization as it allows them to focus on what they do best – provide healthcare services to patients and save lives.
Some of the service providers offers best-in-class and cost-effective healthcare revenue cycle management services, which would positively impact the way a healthcare organization functions. The pioneers in the healthcare revenue cycle management services segment believe in building relationships with their customers by helping them achieve accelerated growth and better process efficiencies.
The best service providers offer smooth healthcare revenue cycle management services, ensuring all the stages of the revenue cycle keep proceeding without encountering errors and bottlenecks. Some major advantages of professional healthcare BPO services are –
- Improve collection ratio
- Optimizing timelines by embracing automation & latest software
- Track of patient’s insurance status and claims
- Increase the probability of payments
- Capturing data and providing valuable insights on claim rejections and denials
- Smooth reimbursement processes
- Smarter error detection to ensure avoidable human errors are eliminated
- Track revenue shortfalls and deliver insights on causes
- Improve overall TAT for the healthcare revenue cycle
- Ensure complete data security and privacy
- Maintaining compliances in a world of rapidly changing regulations and policies