Optimizing RCM for Improved Profitability

by | April 21, 2023 | 3:26 pm
Optimizing RCM for Improved Profitability

For an ambitious and fast-growing HME and DME provider business, one of the keys to business profitability is knowing how to carry out smart financial management. Revenue Cycle Management, or RCM, is the backbone of financial management. This is the process of managing the finances of a healthcare organization, from patient registration to claims processing and payment collection.

Why Optimize RCM?

Optimizing RCM helps ensure business profitability by reducing costs, improving cash flow, and increasing revenue. This can be achieved by effectively managing different aspects of RCM, such as accounts receivable (AR) aging and bad debt. RCM also involves managing the financial transactions associated with a healthcare organization’s administrative and clinical operations. One way to ensure this is by adopting strong medical billing practices that help in streamlining the RCM, thus allowing DME businesses the benefits of better financial management.

Managing Aging AR:

AR aging refers to the amount owed to an DME provider business that is over 30 days old. This money can often turn into bad debt or loss if it is not pursued diligently.

Accounts receivable (AR) aging is a common problem in healthcare organizations that can negatively impact cash flow and revenue. To manage AR aging effectively, healthcare organizations must have strong medical billing practices. This includes accurate and timely claims submission and follow-up on unpaid claims. Both of these can be achieved through optimized RCM practices.

Healthcare organizations can also leverage technology to manage AR aging more effectively. For instance, automated payment reminders and online payment options can help patients pay their bills on time, thereby reducing the risk of unpaid claims and AR aging.

Optimizing RCM

Managing Bad Debt: Bad debt is any unpaid bills that a healthcare organization cannot collect from patients. The business has already provided services or products but cannot collect its dues from the consumers. Prolonged bad debt or unaddressed overdue collections can lead to bad debt that can gradually hurt a business’s profitability and liquidity.   

Optimized RCM practices can help reduce bad debt by verifying patient insurance information upfront, setting clear payment terms and policies, and offering payment plans and financial assistance when appropriate.

Here are some additional benefits of optimizing the RCM:

Increased revenue: By streamlining the revenue cycle process, DME providers can reduce the number of denied claims, identify and address revenue leakage, and accelerate payment collection. This can lead to a significant increase in revenue, which can be reinvested into the organization to improve patient care and expand services.

Improved cash flow: By optimizing RCM, healthcare organizations can improve their cash flow by reducing the time it takes to collect payments from insurers. This can help organizations better manage their finances, pay their bills on time, and invest in new technologies and equipment.

Better cash flow can also help DME providers augment staff or infrastructure, in turn, helping drive productivity.

Better compliance: Optimizing RCM can help DME providers comply with complex regulatory requirements and standards. By ensuring that billing and payment processes are accurate and transparent, businesses can minimize the risk of regulatory violations and penalties.

Increased operational efficiency: Optimizing RCM can increase operational efficiency by streamlining processes and eliminating manual tasks. This can free up staff time and resources, allowing DME provider businesses to focus on delivering high-quality care and improving outcomes.

The Professional Billing Advantage

Optimized RCM practices can help ensure business profitability by addressing AR aging and bad debt. Strong medical billing practices are crucial to achieving optimized RCM, and healthcare organizations can benefit from partnering with claims processing services and medical billing services to streamline their financial operations.

However, for most HME and DME provider businesses, getting staff trained in medical billing processes does not lead to easier RCM or better management of AR and bad debt either. Instead, entrusting the billing process to professionals can help carry out the job more efficiently. This is because, even with training, medical billing is an intensive task. In-house resources can quickly get overwhelmed by the volume of work they must handle in addition to the regular business requirements.

On the other hand, professional billing experts bring their training, understanding, and proven processes to ensure RCM is always effective and reliable.

Next Steps 

  • Professional DME medical billing can provide much-needed support and the right expertise to manage billing processes reliably and efficiently, which can help boost business profitability. Learn more about our medical billing at https://analytixhealthcaresolutions.com/ 
  • Email us at sales@analytix.com or call 781.503.9007 for a complimentary session. 
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