Running a post-acute long-term care practice is a whirlwind of constantly moving pieces, continuously changing as the industry evolves. Whether it’s overseeing patient information or managing your payor enrollment, there’s plenty of work that goes into managing a PALTC practice. But one of the most commonly challenging aspects facing healthcare providers today is revenue cycle management. Balancing this task is far from easy, and ineffective billing and collection systems only make things worse. This is why more and more practices outsource their revenue management tasks for higher efficiency.
But what does this outsourcing process look like? And how can it benefit your practice?
In this guide, we’ll take a look at some of the most common RCM challenges facing PALTC practices today and how outsourcing your revenue management needs can resolve these problems.
Common RCM Challenges
Nothing’s easy when money is involved.
There are numerous hurdles a practice must overcome to find any success in its revenue management. These challenges exist at every stage of the revenue cycle, leaving plenty of room for error. (Luckily, Saisystems’ RCM service manages all phases of your revenue cycle.) Some of the most prominent RCM challenges include:
- Billing Errors: It’s no surprise that claim denials can have a massive impact on your revenue flow, as they usually prolong the entire process. And with claim denials on the rise, more and more practices are replacing their manual processes with automated workflows to avoid these billing errors and streamline the claims process.
- Changes in Regulations and Compliance Standards: As the industry changes, so do the rules. New regulations are a constant in healthcare and create some of the biggest RCM challenges for providers. Without keeping up with the current compliance landscape, practices run the risk of claim denials, payment delays, and even administrative backlogs.
- Inaccurate Data and Coding: To gain any success from your RCM service, you need to be backed by reliable data. It’s estimated that for every dollar spent, 30 cents are lost in the process, all because of incorrect coding practices. Comprehensive data and analytics are a great way for providers to determine and address areas of trouble.
While these challenges may seem daunting and discouraging, they are simple to overcome when relying on an RCM partner. This brings us to…
Benefits of an RCM Partner
Undoubtedly, most post-acute long-term care practices are already operationally strapped and overworked, so why place more burden onto an overflowing workload? By outsourcing your practice’s revenue cycle management needs, you would not only lighten your workload but the workload of your entire organization. In addition, an RCM partner provides an assortment of other benefits, including:
- Patient Billing: As we said before, claim denials can derail the whole revenue cycle process, with some slowing reimbursement by two to three weeks. A dedicated RCM partner such as Saisystems can provide advanced revenue tools designed for quicker, more efficient reimbursement. And with an automated service, payday is quicker and more effective.
- Dedicated and Knowledgeable Experts: A system is nothing without a user. To ensure your practice’s revenue is managed correctly, most RCM vendors should know about changes in healthcare regulations and compliance standards to meet all necessary requirements. This will prevent claim denials or payment delays from disrupting your revenue flow.
- Medical Coding and Analytics: The simplest coding mistakes can result in costly losses. Effective RCM partners should monitor key performance indicators for coding accuracy when managing data and analytics. This will not only reduce coding errors but provide optimal revenue performance for your practice. RCM partners should also keep up with the most recent coding compliances such as CPT codes.
These are just a few of the benefits that an RCM partner can provide. Ultimately, outsourcing RCM tasks should improve your revenue stream and the efficiency of your practice’s organizational capacity.
RCM Partners Wrapped-Up
Managing revenue is no easy feat. It’s a process that takes considerable time, which is rarely available in this fast-paced industry. But that doesn’t mean you can’t have a helping hand.
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