Healthcare providers in North Carolina are under increased pressure to operate more efficiently, both in terms of revenues collected and operational efficiencies, while at the same time providing high-quality patient care. One of the most innovative ways to achieve these objectives is through implementing best practice technology solutions for revenue cycle management (RCM). Providers utilizing modern RCM trends can increase their financial performance, decrease errors, and enhance the overall patient experience.
What is Revenue Cycle Management (RCM) ?
RCM refers to the administrative aspect of operating a health care facility that relates to the revenue cycle – how health care facilities collect revenue from patients, including patient registration, scheduling, pre-authorization verification, order coding and billing, submission of claims, posting of payments received and collection of unpaid balances.
In North Carolina, effective medical billing services help ensure that providers receive the correct amount and on time, and also help to maintain compliance with Federal and State regulations, including HIPAA and CMS Guidelines. RCM assists in maximizing revenue and minimizing claim denials, administrative burden and delays in payment.
North Carolina RCM trends
Due to the various evolving trends, North Carolina Providers are consistently adopting every trend (as indicated below) in order to improve their financial outcomes through their Revenue Cycle Management processes.
1. Artificial Intelligence & Automation: Artificial Intelligence (AI) and automation manage all of the repetitive processes in Revenue Cycle Management, including claims scrubbing, scanning and coding of claims, and denial management. By executing an automated workflow process, Providers can lower their error rates and expedite their reimbursement process.
2. Proper Documentation & Coding of Claims: Accurate coding is a critical component in order to reduce the amount of Denied Claims and also to receive a full reimbursement from the payer. Providers in North Carolina are actively concentrating their efforts on detailed documentation detailing all aspects related to claims and training staff members in all of the latest Coding Standards.
3. Outsourcing of RCM Services: As a result of outsourcing billing to RCM Service Providers in North Carolina it enables practices to focus on delivering a high-quality patient experience while improving cash flow and reducing administrative costs.
4. Patient Financial Experience: Providing transparent billing, with various methods of payments for patients is critical in today’s marketplace. Practices that implement a clear communication strategy for patients who utilize their services typically have much higher patient satisfaction and retention rates.
5. RCM Telehealth Billing Integration: As Telehealth continues to gain in popularity due to a pandemic style of treatment, establishing a Telehealth Integrated process is essential in order to receive timely reimbursement and accurately submit all claims for Virtual Services.
The Financial Performance of Healthcare Providers can be Enhanced with RCM Innovations
- Modern RCM models provide a number of advantages for the healthcare provider that adopts them.
- Decrease the Time between Claim Submission and Payment. Automating the submission of insurance claims results in faster payments.
- Reduce Errors and Rejections when submitting Claims. Employing accurate coding and timely claims submissions reduces denials and write-offs.
- Improve Regulatory Compliance. Timeliness of information regarding regulations aids in avoiding fines and penalties.
- Increase the Satisfaction Level of Patients. Transparent and easy to understand patient billing increases patient loyalty, resulting in repeat visits.
North Carolina healthcare providers have the potential to increase their revenues by adopting these RCM innovations, as well as improving the operational efficiencies of their businesses.
What Steps Can Healthcare Providers Follow to Implement Best Practices in RCM?
If you are a healthcare provider in North Carolina interested in adopting RCM innovations, follow these recommended steps:
- Adopt Technology. Utilize technologies such as AI-enabled devices, electronic health records (EHR), and automated billing software to increase efficiency when processing claims.
- Strategic Outsourcing. Consider forming a relationship with an experienced North Carolina-based RCM service provider for future expertise.
- Training. Train your staff to be proficient in the areas of coding, claim submission, and denial management, to prevent costly delays and losses.
- Monitoring Performance. Regularly monitor the performance of the RCM process by tracking metrics such as the number of days in accounts receivable, claims denied, and collections to determine areas that can be improved.
Why Selecting the Right RCM Partner is Beneficial to Your Practice
A good RCM partner will allow your practice to lower billing mistakes, maximize revenue and be compliant with federal regulations. Partnering with an experienced RCM provider in North Carolina helps medical providers achieve higher efficiency through its expert medical billing services, creating a better patient experience financially.
Providers in North Carolina work with specialized RCM companies like AstroneHS, which offer full-service and specialty RCM solutions tailored to healthcare providers. Each practice receives assistance in achieving financial stability so they may continue to provide the highest quality of care.
Conclusion;
The Trends in Healthcare Billing in North Carolina are Changing Rapidly. Providers that are adopting the latest RCM trends will likely see lower error rates, faster reimbursement times and improved patient satisfaction rates, which will in turn, increase their overall financial performance. Partnering with or upgrading to a 3rd Party Medical Billing Service in North Carolina Is A Smart Business Decision and Will Help Ensure Long-Term Success For Your Practice.