Revenue Cycle Management Software

healthcare Revenue cycle management

From the minute your patients make an appointment to see you, your office staff is tracking the patient’s care’s financial aspects. They may already be using a combination of EHR, a telemedicine platform, and medical billing software. 

Revenue cycle management (RCM), also known as billing cycle management, is a software solution that combines these financial tracking processes and streamlines your workflow. Along with EHR and telehealth platforms, RCM is a vital component of health information management. 

Is cycle management software worth it? The short answer is yes, but don’t just take our word for it, let us explain how revenue cycle reimbursement management works and why it is essential for healthcare providers. 

Common Features of Revenue Cycle Management Software

Here are some of the standard features of RCM software and their functions:

  • Registration and scheduling: Record and track appointments from the outset. 
  • Insurance validation: Gather each patient’s insurance details as they register and confirm their eligibility. 
  • Copay management: Verify copay amounts to adjust the reimbursement.
  • Patient documentation: Record billing codes based on the services and type of patient visit, whether in-office or virtual. 
  • Maintain claim history: Keep a database of current and past claims.
  • Denial management: Reimbursement denials can be organized based on the reason and source of denial. 
  • Patient statements: Send financial statements to patients to see how much they have paid and what is owed. 

The Benefits of Adopting Revenue Cycle Management Software

Benefits of RCM Software

Using RCM management software at your practice can improve the process by:

  • Increasing workflow efficiency: The RCM process enables you to optimize each step of your revenue cycle regardless of your healthcare practice size. Automating your system with a software solution increases your operational efficiency. 
  • Improve financial stability: Because you can track and analyze your practice’s financial metrics, you can assess your facility’s financial stability. 
  • Meet federal compliance: Having medical billing coding at your fingertips ensures that you meet compliance. It also takes the pressure off employees because they’re not overwhelmed by having to edit billing codes.

Best Practices in Revenue Cycle Management for Small Clinics

Healthcare is no stranger to technology, and even if you are running a small practice, it has a place. Your revenue cycle does not have to be paper-based. Not only can RCM software make your practice more efficient. It can also save you money by automating claims. It will also reduce your administrative burden. You can make the most of RCM technology in the following ways:

Focusing on prevention: You may not realize it, but 90 percent of claim denials are preventable. Despite this, many providers are still not taking steps to prevent them. RCM software can help avoid denials by eliminating missing or incorrect patient information – two of the leading causes for reimbursement denial.

Collecting required information: Patient registration and benefits verification can all be collected before the patient shows up for their appointment. The processes of patient data gathering, storage, and maintenance become more efficient. This leaves healthcare providers and their teams to focus on patient care.

Automating prior authorizations: Many clinics spend up to two business days per week dealing with prior authorizations. This adds to the already heavy burden that administrative staff faces. RCM software removes this task and lightens the front-end workflow while still allowing the information to be collected for the backend.

Improving patient billing: Although many patients say they prefer electronic medical billing, most healthcare providers still rely on paper-based billing. Not only is electronic billing more cost-effective, but it also saves time, so your team can focus on keeping up-to-date with changing rules and regulations about health insurance. 

What is Medical Claims Scrubbing?

Many patients assume that having health insurance means that they are automatically covered for their treatment. However, they do not realize that a lot of time, effort, and information goes into each claim. Unfortunately, this can leave room for mistakes, in which case a claim will be denied. 

Claims scrubbing is a process that ensures there are no errors in a claim that would result in denial. Another advantage of RCM software is that it has claim scrubbing functionality. Cleaner claims not only to mean fewer denials, but also less work for your administrative, fewer denials, and an increased cash flow. 

If you would like to find out more about revenue cycle management software, contact our team today. Our EMR experts are dedicated to providing high-quality CCHIT, ONC-ATCB Certified Electronic Health Records Software, and other medical software to small and mid-sized medical practices.