Revenue Cycle Management (RCM) has transitioned from being a back-end office process to an all inclusive end-to-end process. Expert say healthcare providers will be able to improve their cash flows with an RCM end-to-end system in place. This improved system begins at patient-intake or even before altering the old process immensely. What has brought on this new approach was the business model change from fee-for-service to value-based care. With the right automation tools and RCM support, providers can improve their cash flows by:
- Collecting patient payments up front
- Determining precise eligibilities
- Filing clean claims to payers
“Fee-for-service is going away and bundled payments will come to fruition,” he said. “We will see a resurgence of capitation because it puts the risk back on the provider. Organizations were able to overcome ICD-10, but as the model moves toward quality I think we’ll see another resurgence of value proposition payer mixes,” says Jose’ Rivera, vice president of physician solutions development at Santa Rosa, Calif.-based Visiquate.
As a result, Rivera believes that it will be more difficult to get paid. And in order to meet the challenge, providers must become educated on tracking quality metrics and reporting them to payers. An easier method for providers to do this successfully is with a RCM team that has an in-house process for patient-intake, eligibility verification, and claims processing. A RCM specialist can help providers’ practices can boost cash flow and ensure clean claims by collecting patient deductibles, co-payments, and eligibility authorizations at the front-end. RCM technology at the front-end should be leveraging technology for patient data capture, having credit and debit card readers for upfront payments, all while informing patients of their obligations. Providers are usually reluctant to add for payments up front from patients, but with a dedicated RCM team handling this process, providers can suspend that uncomfortable conversation from their to-do list.
Intuitive Solutions Revenue Cycle Management department has an Eligibility Benefits and Authorization (EBA) service that can help you reach financial sustainability. Allow intuitive RCM to handle those uncomfortable conversations, and manage your entire revenue cycle from end-to-end with our EBA service. Contact us today, to learn more!