Revenue Cycle Management (RCM) Services
Freedom to Focus on Care
Our specialized RCM services offer end-to-end solutions designed to capture maximum revenue and boost profits for healthcare providers. We understand that the administrative complexities in individual clinics, group of physicians and hospitals can be overwhelming, often leading to costly errors like incorrect patient information or documentation mishaps
That’s where we come in! With a team of seasoned experts by your side, we tackle everything from Patient registration to claims processing and follow-ups We know that every dollar counts, so we focus on accuracy and efficiency to ensure you get paid faster, enhancing your accounts receivable (AR)
Hamly Business Solutions value software competency to improve claim accuracy, reduce denials, and enhance cash flow for healthcare providers. By staying ahead of industry trends and continuously optimizing our software solutions, we empower our team to deliver exceptional results. With HBS, you can trust that our technological expertise will help you navigate the complexities of the revenue cycle with ease and confidence.
Roadmap of RCM Process
The Need for Executive Involvement in Revenue Cycle Management (RCM)
When it comes to Revenue Cycle Management (RCM), having executives involved is crucial. Their engagement can significantly impact how effectively your organization navigates the complexities of revenue collection. By actively participating in RCM strategies, executives can help set the tone for the entire healthcare system, ensuring that revenue cycle initiatives align with broader business goals.
Strategic Vision: Executives bring a holistic perspective that aligns RCM strategies with the overall goals of the organization. Their involvement ensures that revenue cycle initiatives are integral components of the healthcare provider's mission.
Resource Allocation: Effective RCM requires investment in technology, training, and personnel. Executives are in a unique position to allocate resources strategically, ensuring that the revenue cycle team has the tools and support necessary to thrive.
Cultural Shift: Leadership sets the tone for organizational culture. By prioritizing RCM, executives foster a culture of accountability and excellence, encouraging staff at all levels to engage in practices that enhance revenue integrity.
Data-Driven Decisions: Executives can leverage data analytics to make informed decisions that drive revenue cycle improvements. Their involvement in reviewing key performance indicators (KPIs) ensures that the organization remains agile and responsive to changing market dynamics.
- Expertise and resources working for you
- Better control over operating costs
- Faster claim realization
- More focus on core activities
- Risk mitigation
- Stronger focus on your business growth
To keep your revenue cycle on track, it’s essential to monitor key metrics that provide insight into your organization’s financial health. Here are the top five RCM metrics under every executive's radar:
1. Days in Accounts Receivable (AR)
By tracking how long it takes to collect payments, you can identify trends in payer performance. For example, you might find that some payers consistently take longer to pay, which helps you set realistic cash flow expectations. A typical payment lag might range from 10 to 14 days for some payers, while others may take 21 to 30 days. Understanding these patterns allows for better business planning. AR impact is measured using the following formula:
A lower number indicates efficient billing and collections processes. Reviewing AR impact each month alerts you to any emerging trends related to open AR.
2. Claim Denial Rate
Claim Denial Rate Monitoring the percentage of denied claims can reveal underlying issues in your billing processes. If you notice a spike in denials, it may indicate a need for better documentation or coding practices, rather than a broader operational issue
A high denial rate can signal issues in coding, documentation, or billing practices, necessitating immediate attention to improve revenue capture. Most medical practices target a denial rate of 5% or lower. But it may vary depending on service they provide and scale of practice
3. Net Collection Rate (NCR)
This metric shows how much of your collectible revenue is actually collected. A high net collection rate suggests that your revenue cycle processes are working well, while a drop may signal the need for improved patient engagement strategies
4. Charge Capture Rate
Keeping an eye on your charge capture rate helps ensure that all services provided are billed correctly. If this rate drops, it could indicate missed opportunities for revenue, prompting a review of your billing practices
5. Encounter Billing Lag
Encounter billing lag refers to the time it takes to generate and submit bills after patient encounters. This metric is crucial for understanding how quickly your practice can bill for services rendered. A prolonged encounter billing lag can lead to delayed payments and cash flow issues, making it essential to streamline this process
Choose Hamly Business Solutions RCM Services for
- Achieving the highest level of clean claim submission
- Working with the best medical coders and auditors in the industry
- Getting the most accurate medical billing and coding
- Continuously improving profit margins and revenues through quality assessment
- Obtaining reports that are brimming with authentic data with respect to finance and productivity
- Maintaining the security and confidentiality of your business data
- Cyclical follow-ups on insurance claims and account receivables
- Analyzing and filling the revenue cycle gaps with dedicated strategies and solutions
