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The Main Components of Revenue Cycle Management

The demand for the Successful Management of Accounts Receivables for medical practices has generated a huge market for solutions known as Revenue Cycle Management (RCM). RCM correctly handles the complex regulations that medical providers face to get paid for routine or critical healthcare providers. To make sure there is cash flow in a sector where reimbursement is highly regulated, dentists and physicians must hire people with particular RCM skills. Efficient management of medical receivables is made possible through contracting competent companies. The big insurance providers and Medicare cater to the bulk of the healthcare in the States. The percentage not covered by the insurance companies is covered by patients. With the increased growth in high deductible health plan use, the balances paid for by the patients are going higher. Both these elements of account receivables have to be handled through a time-sensitive and extensive procedure.

Medical receivables management does not start after a patient completes their visit or when the patient signs in for an appointment. Effective RCM begins when the patient schedules an appointment and ends when the individual pays for any amount not paid for by the insurance companies.

There are the main components of RCM, and each is crucial to the cash flow of your medical clinic.
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When the patient calls to make an appointment, the front desk should verify the insurance policy when the patient remains on the phone. They should ask for co-pay amounts from the patients at the check-in before the patient ever sees the doctor. The insurance claim that has the right diagnoses and treatment processes is then submitted to the correct payer electronically through some known standards of submission. If there are any mistakes in the preparation of the claim or submission process, claims that are flagged should be submitted again as soon as corrections are made.
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When claims are paid, the main plaintiff that Is that the Insurance carrier will send a remittance information allowing the billers to post payments electronically and transfer any balances that are owed to a patient or secondary insurance coverage for prompt payment mechanically.

The key to efficient management of accounts receivables is to follow up on them. The providers should inform the billing office of any partial payments, denied claims and even claims that do not have errors but are still unpaid after a specific time. By giving priority to those unpaid claims by the payer, amount, and motive, the representatives of the accounts receivable may review and get in contact with the patients and payers according to the to the status or request for payment.

After tracking the insurance payments and they are applied to the claim balance, the balances that remain are billed to the patient by printing the statements immediately.