Why You Should Hire a NextGen RCM Consultant?

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Why You Should Hire a NextGen RCM Consultant

Revenue cycle management (RCM) is the business process that identifies, collects and manages the revenue that healthcare organizations make in exchange for the services they provide. In most organizations, NextGen RCM is operative from the stage of pre-registering patients up to collecting payment from them.

Role of RCM in Healthcare

The 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 the payers are its key stakeholders.

RCM prevents or minimizes unpaid claims and inefficient coding and billing processes. It improves point-of-service collections. It also maintains healthy accounts receivables. All this together makes a significant impact on profit margins.

RCM is necessary in all healthcare organizations that use NextGen so that care delivery continues uninterrupted and remains profitable. The RCM process consists of the following steps.

  • Translating healthcare services into billable charges.
  • Submitting claims of billable fees to insurance companies.
  • Accurate coding of diagnoses and procedures.
  • Calculating patient balances and collecting payments.
  • Collecting information, such as insurance coverage, prior to registration or any medical procedures.
  • While registering patients, collecting information for medical records and to meet clinical, regulatory and financial requirements.
  • Accepting or rejecting payments via remittance processing.
  • Collecting payments from third-party insurers.
  • Scrutinizing if medical services are necessary.

Your institution should accurately and efficiently implement all the steps in the RCM process to ensure timely reimbursement.

RCM Challenges

With the new interest in value-based and holistic care models, you are constantly under pressure to provide affordable care to patients. You also have to face increases in care delivery and administrative expenses.

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. Moreover, you have little control over payments from the claim review and denial process.

How Can TempBill Consultants Help?

Recently, the healthcare industry saw many changes, from value-based care to the Bundled Payments for Care Improvement Advanced (BPCI Advanced). Also with the popularity of high deductible health plans (HDHP) many organizations are struggling with patient collections.

You should optimize your NextGen Practice Management (EPM) system to cope with such changes. TempBill NextGen EPM consultants, who are well-versed in NextGen and RCM, can help you do so in the following ways.

Planning: TempBill consultants can help draft a budget and roadmap for your institution. This prepares you for all contingencies and prevents small problems from escalating into disasters.

Implementation: Your institution should have streamlined payment processes that integrate front-end and back-end claims processing. They should address the unique needs of individual payers, enabling exchange of information and critical communications through secure channels. TempBill NextGen RCM consultants can help develop and implement such processes and channels.

Review: All organizations should have a clear idea of their finances. TempBill consultants can help you review your financials regularly and determine areas that need improvement.

Problem resolution: Consultants can monitor and measure your NextGen RCM efforts without bias. They can also help rectify any problems in other areas, including communication and payer collaboration.

Compliance and security: TempBill consultants have much wider knowledge of security and compliance requirements. They would also know of the latest developments in the healthcare industry and help you keep up with them.

Training and expert advice: Successful NextGen RCM depends on strong knowledge of the specific system you are working with and a solid base of employees with administrative knowledge, who can work well with all types of payers. TempBill billers & consultants configure NextGen EPM & File Maintenance to a way that is best suited for your institution. They can also train your employees to handle all financial processes.

Overall, TempBill NextGen RCM consultants can improve your institution’s revenue cycle, ease your workload, and drive your institution to success and growth.

To discover more about TempBill: TempDev consulting with a specific focus on revenue cycle management, please visit TempBill’s new page.

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