Revenue Cycle Management (RCM) helps your practice identify, collect, and manage your revenue so your practice stays financially healthy. A NextGen RCM Consultant can help you get paid faster and reduce claims denials using your NextGen EPM system. They can help you examine your entire revenue cycle management process from pre-registering patients all the way to collecting payments from them and insurances. Here is why your practice should hire a NextGen RCM Consultant.
The Role of Revenue Cycle Management in Healthcare
The revenue cycle management (RCM) process is the backbone of the healthcare industry because it manages the finances of healthcare providers. Medical billing and front desk management are an integral part of it. Physicians, patients, and payers are the key stakeholders.
RCM prevents or minimizes unpaid claims and inefficient coding and billing processes. It also improves point-of-service collections and maintains healthy accounts receivable. Together, these improvements can help your practice increase revenue while decreasing costs and improves profit margins.
A typical RCM process includes the following steps:
- Pre-estimation services to provice patient's information about cost prior to visits.
- Collecting information, such as insurance coverage, during registration or check-in.
- Collecting patient copays, deductibles, or coinsurance at check-in where possible.
- Collecting information, such as insurance coverage, prior to registration or any medical procedures.
- Collecting registration information to meet clinical, regulatory and financial requirements.
- Accurately coding diagnoses and procedures during or after office visits.
- Performing medical necessity checks.
- Translating healthcare services into billable charges.
- Submitting claims of billable fees to insurance companies.
- Claim scrubbing and fixing any issues.
- Posting payments from EOB or ERA files.
- Reconciling payments received from insurers and patients.
- Resubmitting any denied claims and working payment adjustments as needed.
- Calculating patient balances and collecting payments.
- Assessing accounts receivable and working overdue accounts.
- Refunding credit balances to patients and payers.
Revenue Cycle Management Challenges
With the recent interest in value-based and holistic care models, your practice is under pressure to boost efficiency while improving patient outcomes. This means your practice needs to maximize reimbursement without creating burdensome new processes for your providers and staff. Your NextGen EHR and EPM system can help. If your billing staff is struggling to keep up with demand, you can automate simple billing tasks to ease their workload and allow them to focus on more complex business needs like working denied or delayed claims.
Coding complexities, duplicate data, and missing information or misspellings can cause errors in billing, which result in revenue loss. Similarly, the constant changes in healthcare regulations and reimbursement models can delay payments. Your practice can address these common RCM challenges with help from a NextGen RCM consultant.
A NextGen RCM Consultant Can Boost Your A/R Performance
Poor accounts receivable (A/R) performance means your practice gets reimbursed more slowly, wasting time and money. A NextGen RCM Consultant can help you identify the root causes of poor A/R performance so you can correct them. For example, a revenue cycle management consultant can review your A/R aging by payer and identify bottlenecks for certain payers. This process can help your practice implement billing, follow-up, and collections processes to ensure more prompt payment. They can also help you determine if the system can be configured or customized to prevent issues from occurring to prevent future loss in revenue.
Using tools like TempDev’s Revenue Cycle Dashboard NextGen EPM Report, consultants can help you identify patterns in A/R to improve your follow-up and collection processes. Revenue cycle management consultants can also help you design workflows and NextGen templates to get your A/R time down to 50 days or less. They can also interview key staff in your organization to understand where there might be process breakdowns to help assist in getting your practice's finances back on track.
How Can a TempDev NextGen RCM Consultant Help?
TempDev’s expert revenue cycle consulting team can help your practice with all aspects of NextGen RCM. TempDev’s consultants can assess your practice management approach and help you optimize your revenue cycle. TempDev also offers NextGen biller staff augmentation with flat rate billers to cover absences, gaps in your billing team, or with special biller projects. TempBill can help at every step of your RCM process, including:
- Planning: Project Management consultants can help draft a budget and roadmap for your practice. This prepares you for all contingencies and prevents minor problems from escalating into disasters.
- Implementation: TempDev can help you streamline your payment processes to integrate front-end and back-end claims processing. They can also help you develop processes to address the unique needs of individual payers, enabling an exchange of information and critical communications through secure channels.
- Review: TempDev consultants can help you review your financials regularly and determine areas that need improvement. Also, with custom templates and reports from TempDev, you can keep track of your key RCM metrics in real-time.
- Problem resolution: Consultants can monitor and measure your NextGen RCM efforts and suggest areas for improvement. They can also help rectify any problems affecting your RCM processes, including communication and payer collaboration.
- Compliance and security: TempDev consultants have a broad knowledge of security and compliance requirements and stay up-to-date on the latest changes. They can help you stay in compliance and keep up with changing regulations.
- Training and expert advice: Successful NextGen RCM requires training. TempDev's experts can develop targeted training for your providers and billing staff to introduce new RCM workflows or implement new NextGen processes.
- Billing assistance: Whether it's AR follow-up or credit balance clean-up, we have a staff of trained NextGen billers ready to help you take on your special projects to help you get caught up. WIth a flat-rate cost and a minimal commitment, you will always know exactly what you are going to pay with no surprises at the end of the month.
Call us at 888.TEMP.DEV or contact us here to get started boosting your revenue cycle with help from a NextGen RCM Consultant.
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