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5 Must-Have Features in Revenue Cycle Management Software: A Guide to Help You Select the Right One

kokou adzo

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Unsettled financial transactions are one of the biggest challenges healthcare experts face in the medical and behavioral health sectors. 

Many a time, it’s the disorganized revenue cycle that results in a stockpile of uncollectible. In addition to that, the lack of proper employee training creates a mess in the revenue cycle, affecting return on investment (ROI). 

Errors in medical billing and coding are yet another reason behind delays in compensation. Ultimately, this leads to claims being delayed or providers don’t get paid at all in the worst-case scenario. Unless practitioners optimize the revenue cycle, uncollectible money will continue accumulating and affect the bottom line of healthcare clinics. 

Because this non-medical medical work is time-intensive, a few healthcare practitioners have turned to revenue cycle management (RCM), while some are still apprehensive. 

Quoting a recent study conducted by Fortune Business Insight, it is estimated that the revenue cycle management market will grow by $246.40 billion by 2029. Now that’s a whopping amount! 

Taking everything into account, leveraging the services of a revenue cycle management company is a necessity to streamline the workflow and improve cash flow. But how do you select the right RCM? This guide will help you with that, so read it until the end. 

5 Must-Have Features in Revenue Cycle Management Company

The following are the features that you should look for when choosing an RCM for medical billing:

1. User-Friendly Interface

Revenue cycle management with a complex interface wouldn’t simplify medical billing but make it more challenging. On the other hand, RCM with an interactive interface will be easy to use, and carrying out workflows won’t be too much of a task. 

Even staff won’t take too long to get accustomed to the software, meaning there would be fewer delays in submitting claims. At the same time, leveraging the services of a revenue cycle management company will save time and resources that would have otherwise been spent on employee training. 

In order to help healthcare facilities with medical billing chores, quite a few organizations, like Millin Associates, have been offering revenue cycle management services to health agencies since 1982. The rule-based RCM of Millin Associates can be integrated with the accounting system and EMR/EVV of healthcare providers’ choice. 

Currently, its RCM is leveraged by more than 350 agencies, including I/DD, mental health, health home, foster care, and substance use. Because it automates and streamlines several tasks of claims management, like processing payments and keeping track of denials and rejections, it reduces the workload of clinic staff. 

2. Claims Tracking

In order to ensure practitioners receive compensation for services rendered, submitting claims on time is necessary. Any error or discrepancy in claims can result in claims being denied, which hampers the revenue cycle. 

A revenue cycle management software must be integrated with a claim tracking feature, which would also point out errors. Because of such a feature, clinic staff will be able to make the required changes with ease and resubmit claims with accurate details. 

3. Eligibility Verification

There’s nothing more tedious than verifying patients’ eligibility manually. Prior to the introduction of technological advancements, the verification process was conducted over a phone call. However, revenue cycle management software has simplified this process, as it can fetch information on patients’ insurance coverage and verify claims quickly. 

Always check whether the RCM platform you’re planning to go for is integrated with patients’ eligibility verification feature or not. Another significant benefit of this feature is that errors in the claim procedure are minimized, which isn’t possible manually. 

4. Secure Payment Gateway

Another important feature that an effective RCM software must have is a secure payment gateway. Besides cutting down costs and saving time, a secure payment gateway keeps data safe and minimizes errors in billing. This, in turn, accelerates the provider’s compensation for services provided. 

5. Performance Reporting

A medical revenue cycle management software that reports performance helps clinics and hospitals improve their revenue cycles. Typically, the performance report highlights the primary reasons for claim rejections and denials. It also shows the least denying payers and the most denying payers. 

Based on such information, hospitals and clinics can take proper measures to optimize revenue. And as compensation from insurance companies account for the majority of healthcare revenues, these insights help practitioners identify the sources of inefficiencies. Hence, they are able to make sound decisions. 

Leverage the Right Revenue Cycle Management Software Today

For the healthcare industry, RCM software has become an indispensable part because it simplifies the workflow by filing and submitting claims in good time. It also minimizes errors in billing, ensuring you receive compensation without delay. 

Without an RCM solution, healthcare practitioners will have to spend a major chunk of time and resources on billing. And because of this, their primary goal, which is taking care of patients, will take a backseat. 

To improve cash flow and reduce errors in billing, partner with an RCM without delay. 

 

Kokou Adzo is the editor and author of Startup.info. He is passionate about business and tech, and brings you the latest Startup news and information. He graduated from university of Siena (Italy) and Rennes (France) in Communications and Political Science with a Master's Degree. He manages the editorial operations at Startup.info.

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