Partnering with a revenue cycle management company is the perfect option for many medical practices. However, if an RCM is not offering even the most basic level of service, in that case, it’s in your best interests and the interests of other practice stakeholders to consider these six reasons to part ways with your existing revenue cycle management company.

1. Transparency Issues  

If your practice does back-office work such as billing or payroll, make sure you take the time to check on them periodically. You want to ensure you get all the money that could be going in and avoid unnecessary delays. This is why you must collaborate with a reputable RCM partner. For example, you must be able to view the status of all pending patient bills to get a sense of how the cash flow is developing.

Thus, you can anticipate having access to the data around-the-clock. The RCM specialists should always be able to explain the revenue stream’s state supported by verifiable facts.

  • The RCM specialists should always be able to explain the revenue stream’s state supported by verifiable facts.
  • You can anticipate having access to data around-the-clock.

2. No Simple Way to Easily Check the Patient‘s Eligibility 

The revenue cycle management requires quick access to determine each patient’s eligibility. They should be connected to all significant healthcare providers and utilize cutting-edge networking and computer systems with high levels of security.

The revenue cycle management would require the following:

  • Vital networking and computer systems with high levels of security to connect with all significant healthcare providers
  • Quick access to determine each patient’s eligibility

Verifying the status of the patients you care for should be simple. Given our capacity to interact electronically via secure channels today, delays resulting from dealing with complex insurance providers and being compelled to play phone tags should be eliminated.

3. Lack of Prompt Notice of Claim Denials  

The cash flow in your healthcare facility is improved if you know that a certain percentage of the patient say your submitted claims have an issue, such as a coding error or missing facts. Reimbursement takes longer the longer you wait to respond with corrections. Your RCM partner should be on top of these matters and always keep you informed.

4. The RCM Team Provides Poor Customer Service 

Successful collaboration between healthcare providers and the industry experts handling revenue cycle management depends on open communication. To help healthcare providers and their clients better understand the organization’s expertise and services, Medical Billing and Management has introduced an interactive website. The new site includes a comprehensive list of the company’s services and a detailed description. Services include provider transitions, healthcare consulting, revenue cycle management, medical billing and coding, medical office administration, medical billing education, and more.

The website also includes a blog with healthcare-related articles to help providers and their clients stay abreast of changes in the field. Medical Billing and Management has been providing billing and revenue cycle management.

5. There Are No Assurances that your RCM Partner will Increase Revenue

To deliver more of your money to you faster, RCM professionals should be thoroughly conversant in all rules, regulations, and industry best practices. They are taught to work more efficiently than a provider’s back-office employees. Finding a new RCM partner is necessary because there is no assurance that your revenue will improve.

6. Lack of Cloud Option 

Contemporary medical offices use cloud computing service providers to bring their computer systems online gradually. A warning sign is if the RCM supplier you have been working with is not adhering to industry best practices and does not give a cloud option.

The Consequences of Poor Revenue Cycle Management 

Apart from the above-mentioned primary reasons that your current RCM software is not suitable for you, there are some consequences of poor revenue cycle management.

Partnering with an RCM support provider can help ease the pressures associated with duties like eligibility, authorization, billing, claims filing, rejection management, accounts receivable, appeals, and more. Revenue cycle management can be time-consuming for your team. Given that these procedures ought to be as well-oiled as feasible, it should be no surprise that during the COVID-19 pandemic, 75% of health systems installed RCM support technologies.

When your practice leaves money on the table, it suffers from a terrible financial situation, a stagnant business, a toxic workplace, and dissatisfied clients. The following are some of the consequences of poor RCM.

  1. You Might be Wasting a lot of Cash 

The most noticeable side effect of bad RCM is poor financial health. Errors in your billing procedure may cost you up to 20% of your actual income.

  1. No Money, No Expansion 

Your practice may need a robust RCM process that guarantees you get paid on time to invest in other business areas.

  1. You Risk Burning Your Staff 

One of the few procedures that span both front-end and back-end operations is the RCM process. Front-end administrators enroll new patients, collect insurance information, and handle critical prior authorization and eligibility activities, while back-end billing teams submit and manage claims, denials, and collections.

  1. The Patient Experience Suffers 

Practices should take every possible step to convey patient accountability for care costs. Your chances of receiving payment are better the more open you are with your patients. A terrible patient experience means a wrong impression of your practice.

Bottom Line  

This guide explains the six primary reasons why your current RCM is unsuitable for your practice. The guide also explained some of the consequences of poor revenue cycle management and how poor RCM leads to loss of revenue and poor overall efficiencies

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