A Tale of Transformation in Revenue Cycle Management

Revenue Cycle Management (RCM) is often overshadowed by healthcare’s countless responsibilities. Let’s take a journey into the uncharted territories of RCM, looking at how hospitals and medical practitioners manage their financial health. Think of a world where administrative burdens are lifted, resources are optimized, and revenue streams flow seamlessly. Here’s the story we’re about to tell—it’s more than just a dream.

In this Article

A Closer Look at Revenue Cycle Management (RCM) Statistics

Beyond the commonly shared statistics, let’s shine a light on some lesser-known figures that paint a vivid picture of the challenges faced by hospitals and medical practitioners. Did you know that, on average, hospitals take 15-20 days to submit claims? Or that claim denials contribute to a revenue loss of approximately 5% annually? These numbers underscore the critical need for a finely tuned Revenue Cycle Management system.

How Atlantic RCM is different from other firms ?

Atlantic RCM stands out in a landscape of revenue cycle management challenges. Amidst the noise of traditional solutions, Atlantic RCM stands tall with its cutting-edge RCM Automation Software, a game-changer for healthcare financial management. By seamlessly integrating into existing workflows, our software optimizes revenue cycles, reducing claim submission times and mitigating denial rates. This isn’t just about efficiency; it’s about liberating healthcare professionals to focus on what matters most – patient care.

Revolutionizing Revenue Cycle Management (RCM) with Atlantic RCM

Understanding Atlantic RCM’s unique value proposition is crucial as we weave through the complex web of Revenue Cycle Management Services. Consider a world where claims are processed quickly, billing errors are minimized, and financial health is an indicator of operational excellence. Our automation software achieves just that, offering a transformative approach to revenue cycle challenges.

While most RCM services focus on technicalities, Atlantic RCM delves deeper, crafting an experience that is not just efficient but also patient-centric. The ripple effect is a healthcare ecosystem where financial sustainability and compassionate care coexist harmoniously.

Frequently Asked Questions (FAQ’s) about Revenue Cycle Management

Managing the revenue cycle (RCM) facilitates alignment between the financial operations of a business and its strategic goals. The RCM process includes collecting payments, physician billing, and collecting. The ability to stay ahead of the curve and ensure operational efficiency requires an effective RCM solution from a reliable partner.

How Is Healthcare Billing going to change over the next few years?

Payer authorization challenges will persist for some time to come, so ensuring clear medical records and documentation is essential in order to facilitate prompt payment and prevent claim rejections.

The use of automation and predictive analytics will also increase in healthcare billing in the near future, as well as cloud-based solutions.

Currently, what are the biggest billing challenges?

Our biggest problem has been obtaining authorizations from payers. Healthcare costs are on the rise, which is responsible for this trend.

As healthcare costs continue to rise, many insurance companies will have trouble keeping up with claim payments, which is why extended inpatient stays or other costly treatment options must be justified.

Facility billing for services that were not provided, overbilling of services, or improper coding of services may also have contributed to difficulty getting payer authorization.

In what ways does Atlantic RCM implementation differ from other RCM implementations?

During the implementation process, Atlantic RCM will communicate with your team on the roles the RCM will take over, which will be left to your team, and a brief discussion on your facility’s current financial situation and the expected Return On Investment (ROI).

A standard implementation protocol for Atlantic RCM involves setting up the product at your facility and training on revenue optimization.

As part of the standard Atlantic RCM implementation, the following features are included, but not limited to:

Revenue collection
Compliance with contractual terms and evaluation of collections
Invoices and other billing documents are prepared and submitted
Receivables and payments management
Measuring and reporting performance

Can you recommend some billing tips for facilities?

A vital billing tip is to code all treatment options and modalities correctly. Verify that your payment authorization requests correspond to the level of service(s) you have provided.

The following tips may also be helpful when it comes to billing:

Use healthcare billing software to automate billing processes and make tracking and reporting easier.
Health care facilities can provide their patients with the most up-to-date information by creating custom bills.
Keeping track of receipts can assist healthcare facilities in getting reimbursed for all costs associated with providing care for their patients.

How are claims typically rejected or submitted incorrectly for facilities?

Poor coding and lack of payer authorization are the most common reasons for treatment claims being denied.

It is crucial to obtain payer authorization before commencing treatment and to use the correct revenue codes or CPT modifiers. In addition, revenue codes and CPT modifiers are not universal, so it’s important to verify which type each payer uses.

Any healthcare facility may also be rejected for the following reasons:

Evidence is insufficient
An untrue statement
Activity that is fraudulent
Claims that are duplicates
Benefits used inappropriately
Filing of a claim too late

Most claim rejections can be prevented by proper due diligence on the facility’s part, which will result in faster claim payments. In the event of coding errors or strong evidence that the payer was at fault, it is important to appeal rejected claims.

Is there a recommended type of financial reporting for facilities?

Financial reporting that can consistently, accurately, and timely report revenue and expenses will suffice. Health insurance companies will be able to make accurate payments if claims are properly processed.

Although accounts receivable (AR) should be monitored for aging, it’s good practice to keep track of this information. It is the responsibility of a health facility to ensure that its credit risk is low or manageable. The aging of AR can be monitored by tabulating unpaid invoices every thirty days. Facilities should always encourage or pursue early payment of way overdue invoices, which are the least likely to be paid.

The following methods can be used to manage AR aging and credit risk:

Actively invoicing and collecting – Atlantic RCM provides this service
Adopting aggressive collection practices for overdue invoices
Providing discounts for early payments
To monitor progress and identify improvement opportunities, healthcare facilities should track key performance indicators (KPIs)

What makes Atlantic RCM the right choice for you?

It has been our pleasure to provide our clients with end-to-end revenue cycle management solutions for over 25 years in a HIPAA-compliant environment and our servers are SSAE16 and SOC2 Certified.

Our in-house automation software – Atlantic RCM – insures more than 520 insurance companies. The software can retrieve the status of up to 50,000 claims per day and verify eligibility and benefit eligibility for more than 1000 insurance companies nationwide. This is done in real-time.

99% of Atlantic’s customers remain with the company. There are many reasons why our customers choose to stay with us year after year

Atlantic RCM helps to increase revenue on a daily basis. As a result of our efforts, we have been able to increase revenues for our clients by over 30%. With our automation tool, which is the best in the industry, and our highly experienced account receivable team, we are able to deliver significant gains in client revenue.

Atlantic RCM Services

As a medical billing company, Atlantic RCM offers a wide range of services that include the following:

Conclusion

With Atlantic Revenue Cycle Management Services, hospitals and medical practitioners can benefit from a seamless melody of financial harmony.

As we navigate the uncharted realms of Revenue Cycle Management, the question arises: Can you afford to overlook the transformative power of Atlantic RCM? In a world where every penny counts, the answer may just lie in embracing the untold possibilities of our RCM Automation Software.

As one of the top multispecialty medical billing companies in USA, Atlantic RCM provides a wide range of services to help medical professionals across 25+ specialties. It is our goal to help you succeed across all areas of your practice, including billing, collections, and account receivables management.

We invite you to contact the leading medical billing outsourcing company to learn more about the services we offer. Please contact us by calling (469) 501-1500 or by writing to info@atlanticrcm.com if you have any questions

Atlantic RCM is one of the leading multi-specialty medical billing companies in USA that serves 25+ major medical billing specialties. Our experts work across your practice in billing, collections and account receivables management, to help you succeed.

Get in touch with the leading medical billing outsourcing company to learn more. Call us at (469) 501-1500 or write to us Info@atlanticrcm.com