RCM performance typically improves when all billing functions follow common guiding principles. Providers must constantly modify processes to ensure continuous improvement and respond to ever-changing government regulations. Although there is no set formula for making improvements, many providers are refining processes in similar ways:
Enhancing the patient’s experience
Optimizing RCM processes
Implementing time-of-service collections
Although providers pursue a variety of strategies to attain revenue cycle excellence, high-performing RCM practices don’t just happen. Practices that use patient-focused and value-driven revenue cycle processes have done so by leveraging integrated technology and dynamic RCM teams (like UMB) and committing to their policies, procedures, and protocols (PPP).
We look beyond just tracking a claim, your revenue cycle encompasses all the many steps from when a patient first makes an appointment to the time when there is no longer a balance on that person’s account. It includes front-end office tasks like appointment scheduling and insurance eligibility verification; tasks related to clinical care like coding and charge capture; and back office tasks like claims submission, payment posting, statement processing and the management of denied claims. The extent to which your practice has a handle on these steps directly impacts your ability to get paid the full amount you are owed as quickly as possible.