Why Revenue Cycle Management Services Remain an Important Consideration for Hospitals

While facing the reality of a pandemic, it is essential for rural hospitals to maintain good RCM processes. An external RCM service can provide expertise that is difficult to find in a rural setting, ensuring good coding and billing with each claim, ensuring all denials, reductions and insurance issues are worked immediately to maintain your revenue stream. 

            RCM services can work with patients to verify eligibility prior to appointments, helping to bill new services almost immediately. Their expertise can also help to ensure correct modifiers and diagnoses are used to avoid denials, maximizing revenue per claim, while also supporting managed care services.  

            A good RCM service can help recover outstanding debts, limiting your AR cycle. It can also help ensure new claims are submitted in 24 hours Turnaround Time, auto Insurance and workers comp claims are filed with MR to avoid processing delays, clearing house and payer rejections are fixed within 48 hours, and client escalations are worked on and completed by the same day. They can also make patient reminder calls about past dues. 

            Rather than 60+, new AR for Medicare and & low TFL cases can be worked at 25+ days, regardless of value. 45+ plus Claims can be worked for all commercial carriers, and findings can be reported through summaries prepared and discussed with the client. 

            All of these processes can be harnessed to ensure your revenue meets or exceeds pre-pandemic levels. Hospitals using these services have seen their overall collections increase by 20%. 

            Rio Grande Hospital in Del Norte, CO has recently discovered the benefits of an RCM service. You can read about their journey here.