Revenue Cycle Management Case Study

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The relationships between healthcare providers, patients, third-party payers and practice extender create opportunities and challenges for today’s physicians. Engaging external partners to facilitate revenue cycle management can mean the difference between a practice that enjoys a healthy financial status and one that struggles to make ends meet.

How much do Revenue Cycle Management (RCM) Services Cost?

There is not a standard fee for RCM services. Each contract is individually crafted to precisely match practice business goals, patient needs and staff resources. Contracts may cover the end-to-end revenue cycle, or provide only one service, such as coding and billing.

Are RCM services primarily focused on the billing and coding?

The
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Payer rules are complex. Failing to meet payer guidelines may mean lost revenue. A professional billing and collections agency assumes financial responsibility for filing errors. Reputable vendors constantly update payer rules and invest in staff training which ensures denials never fall through the cracks and accurate, timely filing prevent claims from being submitting beyond the approved window of opportunity for reimbursement.

Does hiring an RCM service provider include training?

Revenue management tools are only as effective as the staff engaged with the technology and resources. Every RCM service package includes customized training to enable accurate data transfer and reinforce best practices and techniques that allow a practice to utilize the system to its fullest potential.

Are there other ways that services can help medical practice administrators meet business goals?

Yes, one example is reviewing staff workloads and schedules to ensure each employee is working smarter, not harder. Taking a close look at schedules and productivity may reveal opportunities to reassign workers during slow times to focus on practice marketing or patient

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