Tackling Bottlenecks in Revenue Cycle Management Before They Create Issues

Where is the quality of your revenue cycle found? Maybe it’s the coffee that keeps your team coding and billing, or the music they hear when on hold with insurance companies. Those sax tunes are catchy and toe-tap-y, just one man’s opinion. The reality is that the link between where your revenue cycle management team, their ability to collect the payments that you are due, and your office’s internal processes and procedures meet is where the magic is. You have a few options if upon review you find that there’s no real “magic” and the fog is lifting to less-than-stellar income for your medical practice. We have several solutions you could ruminate over:

The Billing Models

• The majority of your billing occurs in a central business office.
  • The advantage here is the consistency, standardized reporting, efficiency of monitoring and tracking as well as dedicated expertise and enhanced billing resources, and better systems. The downside of this might come in the form of the higher cost for billing services, the mindset that a third party may have that it’s not “their issue” if the bill is paid, and slower or inconsistent reporting.
• A decentralized billing model is one that is used commonly as well.
  • In this billing option, the revenue cycle management happens at the site of service. This allows your organization to have all of the control and clear observation of the entire process, offering you prompt discovery of any office-driven or physician oversights or errors and more rapid resolution.
• In the out-sourced model, which Gables Medical Billing is a great example of, you have all of your back-end functions managed by a third-party company.
  • This model allows your office staff to focus on your patients and their needs, instead of worrying about the revenue cycle and all of the taxing issues, like timely filing and re-submitting claims. You’re more likely to have repeat patients with an office staff that is completely concentrated on the care of the patient and their concerns. This will also free up your budget from having to hire on-staff billers and coders and constantly update your systems to keep up with all of the legal and federal statutes and bylaws.
  • Gables Medical Billing has a vast amount of experience in appealing denied and underpaid claims.
• There’s also the hybrid billing model.
  • This is a mix of both, a central business office and decentralized business models, it gives the organization the best of both worlds, though it requires more implementation and training for staff on reporting and oversight tools.

At the end of the day what you need is an organized and coordinated practice system. You also need a dedicated, well-trained staff of support professionals that conduct your billing. You also need to have accountability between the front- and back-end of the billing process. As well as proactive policies and procedures, and clear performance expectations. Another deliverable that will help you efficiently move through your revenue cycle management is reporting and performance metrics. Coming to Gables Medical Billing to help you move your revenue cycle management into a more effective and productive stream of funds for your practice is a brilliant idea.