The automated process from the scheduling of appointments to billing till the final payment of cost is covered under revenue cycle management. You can automate and outsource this complex process in the form of remote working.
The revenue cycle management has the following four basic processes:
Verification of the insurance
This is the primary process for all settlements. It has to be clearly understood by both the patients as well as the doctors, as to which portions are covered by the insurance. There should be no hidden charges involved in this step because the hidden charges would hamper the smooth working of the automated system.
Creating the patient superbill
This process includes working along with both the patient and doctor for creating a complete bill of the expenses. When the patient knows of the complete expenditure, then it would be easy for them to arrange for payment accordingly.
Claim submission and denial management
Early submission of claims is required for having low denial rates. Some denials happen due to errors in submission. So if the claims are submitted early then the mistakes can be rectified and the settlements can be completed on time.
Payment and reporting
The final step in the revenue cycle management. The quicker the payment, the better it is for the hospital. Once the payment has been settled, then the record should be properly maintained for future reference if required.
All these above steps contribute to the cost-to-collect. The primary motive is to keep the cost-to-collect to a bare minimum as possible.
For managing this structure, hospitals can take the help of revenue cycle management services. Several companies provide outsourcing for the RCM in hospitals in India.
Advantages of remote work in Hospital Revenue cycle management
It has been found that post-Covid 19 more than 75% of the hospitals globally are planning to permanently make Revenue cycle management operations from remote locations. This process has found a widespread advantage because of the lower cost required for running the machinery.
The main motive for outsourcing RCM in hospitals is for lowering the cost-to-collect. So top revenue cycle companies need to ensure that this process is fully efficient.
The hospital revenue cycle management is mostly outsourced to clients who mostly operate from a neutral place outside the hospital. There are a lot of expenditures such as the rent of the place, and functional charges like electricity, water, etc.
The Covid lockdown forced a lot of these institutions to work remotely without any proper machinery. The toughest phase also proved to be the experimental phase. Lessons were learned, and the systems were upgraded so that this work could be done remotely. This eliminated the extra expenditures leading to better margins for both the hospitals and the billing companies.
Useful Tips for Remote Work in Hospital Revenue Cycle Management
The hospital RCM is more complicated as compared to other workplaces. This is because multiple points may cause multiple issues. It is therefore necessary to design a structure that can make this process move smoothly.
Consolidation of systems
Generating a system that unifies data from all sources such as appointment schedules, registration, and payment. This would provide a better idea for analyzing how long it takes for the patient to make a full payment. This system would be able to forecast future trends and thereby help in quicker settlements.
Focus on the patient
You should note that you need to give more focus to the patient. No one should judge the patients initially if they will be able to pay for the treatment. Successful ventures always focus on customer satisfaction. Similarly, physicians who are good at their trades earn more money from such trades as compared to other physicians.
Even though it is essential to take care of the patients, the pricing should be transparent. Inform the cost to patients before starting the process. This will make the patient aware of the approximate charge they need to make beforehand. Also, try to collect basic financial details from the patients. A credit card number would provide a better idea of the financial condition of the patient.
Have multiple methods to receive payments
Having more than one payment option provides a cushion for the patients. This helps them to use multiple methods to make one payment. Having multiple payment options also requires a system to monitor incoming sources from all funds, to have a proper understanding of the flow of finances.
Improving the backend system
The backend system should be a vital part of the process. Imagine a doctor spending more time managing accounts, this would lead him with little to no time for performing his duties.
The backend operations should take complete care of the settlements. This would include payments made through checks, phone systems, or mail. The backend operation team should make sure the credit to the hospital account happens on time and eliminate all sources of delays.
You need to note that remote working is the way ahead. Improving database systems and cloud management tools would come in handy for a smooth process. The ability to remotely work on hospital RCM would have a big impact on the cost-to-collect. Well, this move will highly benefit the hospitals. Doctors would be able to concentrate more on their profession and worry a little less about the flow of finance.
The top revenue cycle companies in India would be benefitted from this because they would be able to set up remote operations in the Indian healthcare system. There are already numerous companies that are currently working for hospitals situated in different parts of the world. However, it would require a lot of hard work and effort to set up a remote RCM system for the vast Indian healthcare system.
The insurance claims process would have numerous criteria here because of the different types of people and their eligibility. The primary motive should be maintaining the data properly, which would act as the root for the entire remote working system to function.