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Outsourcing The Revenue Cycle Management System During Covid-19

Updated: Jul 14, 2023


Life after the COVID-19 will be different. Telehealth is no more a dream. We need to educate people about telemedicine. Telemedicine is the process by which a registered medical practitioner offers medical diagnosis and advice to the patient through the use of Medical Technology and communication system.

Telemedicine is the natural selection of medical practitioners nowadays, due to standard operating procedures of physical distance due to COVID-19. Telehealth has become a new standard for the universal health care system.

System of telemedicine was present even before the COVID-19, but its reach was slower because of the head is the hesitation of patients. There were various software available in the market for Telehealth and telemedicine what patients were used to visiting doctors for their Healthcare issues.

Nowadays, the management of hospitals rigorously researching the right Healthcare software for their use. In this time, when doctors are losing their lives while performing their regular duties. It is the need of the time that we have a remote health system where doctors can virtually check their patients without any problem.

The problem with COVID-19 is that it is a hidden enemy. Sometimes a person without any symptoms is a potential carrier of the virus. In this case, the use of Telehealth facility if the need for time, which saved the lives of doctors and patients because it is not possible to test every patient for coronavirus. The available prevention from COVID-19 is physical distance.

The health officials of Telehealth facility, rigorously offering Tele healthcare practice for the world. We can select the best facility by searching for the most significant platform on the internet.

In an economic slowdown or recession time, management can still consider outsourcing the revenue cycle management task optimally.

What is a revenue cycle management crisis amid COVID-19? The routine of the regular visit of patience is disturbed during this pandemic. The result is that the medical industry is disrupting the billing cycle. In the following ways, one can reduce the operating cost of revenue cycle management.

Avoiding Claim Errors:

According to the American Medical Association, we can save up to $100,000 per month if we can take care of underpaid, rejected claims. In this time of crisis, the careful examination of patients can save our hard money.

We can get rid of an insurance claim and Reclaims by accurate analysis. It will save time and cost, and it will speed our efficiency time. How can we avoid claim errors at this time? We can understand some common administrative mistakes that happen again and again. These errors are:

  • Incorrect input of insurance ID

  • Mismatching of treatment codes with diagnosis codes

  • Wrong information on demographic data

We can solve these common errors by proofreading it. Some advanced electronic health record software systems have features that alert the software uses about the mistake during the input process. Proper training is needed because it will eliminate any errors in the screening of the claims.

A certified professional coder is the need of the times. Professionalism can give optimal results in revenue cycle management by providing internal audit; ensure coding accuracy and ongoing training to the coding internees.

Denial Management:

A hospital cannot accept and reject all insurance claims. The process needs to be objective and error-free. In this way, the administrative costs can be minimized. It is the bottom line of revenue cycle crisis management.

Once the screening is correct, and the data correctly entered into the software. The Hospital can start its Optimization by merely doing this process. The denied and rejected claims should be seen from objectivity. If this process is immaculate, a long stride made toward the Optimization of revenue cycle management.

Trained, motivated persons can only avoid clerical. The productivity of the health care system lies in the motivation of data entry operators. For this purpose, software should be up to date so that the repeated errors don't come.

Continuous training of data entry operators will provide sure quality insurance apart from quality control. The motivation of coding implies decreases with repeated reclaims, and they have to pay double pressure management from the patients.

For this purpose, we can only be compensating them financially, teaching them the scientific method of screening the complaints. We can educate patients which can help reduce the number of reclaims by giving them information about

  • Complete the procedure of your insurance and match the Hospital's requirements.

  • Read reimbursement guidelines.

How To Control The Revenue Cycle:

We can control the revenue cycle by calculating medical billing and comparing it with the benchmark. There are some parameters which are necessary for our journey towards optimal revenue management cycle:

Accounts Receivable Outstanding

Account receivable is the average days it will take our practice to get rewarded. It is a loan period for us. The account receivable is better than the non-visiting of the patient; it will create hope for us to get it. The lower the cycle of account receivable outstanding, the better it is for us to get paid. It should not be more than 45 days.

Cash Receivables

Cash help hospitals to daily expenditure. Petty cash is beneficial for hospital management when accounts receivable are outstanding.

Denial Rate

The rate of claims should not be higher for management. Rate of 5-10% is acceptable but higher than it is bad management. So the Hospital needs to take care of it.

How To Choose An Outsourced Medical Billing

Present Healthcare management believes that Outsourcing revenue cycle management is necessary to reduce spending and focus on value-based care operations. Some think that outsourcing is expensive than in billing, but it is 4-10% of the exclusive collection.

One can easily do the cost-benefit analysis. In this time of COVID-19, the operation cost of the management is very high, and one cannot afford clerical mistakes when the business is closer to the break-even point. Outsource medical billing offsets the following expenses for the medical practitioners.

  • Employee salaries and wages.

  • Benefits costs like vacation costs, Health Insurance costs, retirement plans costs, social security costs, etc.

  • Training cost.

  • Real state cost.

  • Recruitment costs.

  • Supervision cost.

  • Software cost.

  • Claim cost.

  • Equipment cost and supplies cost.

  • Technology up-gradation cost.

  • Communication cost.

  • Billing error cost.

As the rate of the cost of each Hospital will be different, but these are the compulsory cost. During this crisis, hospitals are thinking about their survival, so; extra expenses need to be minimized.

When you calculate the in-house costs and match it with outsourcing, you will come to know that outsourcing is much beneficial in the long run. These costs are above 10% of the net collections, and if you add the error rate in, it will become double.

The bigger the organization, the higher the in-house cost and vice versa. So, the big Hospital should outsource the revenue cycle management system in this crisis. They have higher in house costs, as stated above, so if the amount of charge for the smaller hospitals is also higher as compared to their in-house price, then they have also to outsource their revenue cycle management system.

How To Outsource The Right Revenue Cycle Management:

Shifting one system to another is not an easy task. It is a strategic decision, and it requires long term planning. Our correct decision will make or break us in the future. The sudden shift has not recommended. One has to think about the present staff and do a SWOT analysis cost-benefit analysis before moving towards the decision.

One more cost should be added when switching towards outsourcing, which is layoff cost. No one knows when this pandemic will end; there is no vaccine for it. And new businesses designed for the future. Simple calculating all these costs will lead us to a decision it is more viable and practical.

The term and conditions with the outsourcing firms need to carefully design, and maximum advantage should gain in the contract. The communication gap should not be present with the outsourcing firm as it is the only lifeline between you and the outsourced revenue management system.

Systematic meetings should arrange, and contingency planning should be done along with the outsourced revenue management system. There should be some reliable in-house personnel who can cross-check the working of the outsourced company.

The change plan should work step by step. It will help us from a setback. The company's market ratings should be viewed, and the outsourced company's professionalism should be observed.

Final verdict:

People are more secure in homes than in Hospitals. The more people will follow social distance, the more they will be safe from COVID-19. It is easy for the outsourcing company to manage telemedicine and Telehealthcare system as compared to in-house employees.

Entire countries encourage their populations to stay at homes to avoid COVID-19. In this dangerous situation, healthcare providers are more active than ever to serve patients of coronavirus and other diseases. This practice is having a significant impact on the healthcare revenue cycle and provider finances.

However, COVID-19 is creating unique healthcare revenue cycle challenges around billing and coding, patient financial responsibility, and resource allocation.

It is a solid point for the outsourcing of the revenue management cycle system. Outsourcing will help the Telehealthcare system to flourish, making our lives much safer than before Amid COVID-19.

Revmedi offers the best solution for all medical billing and coding needs starting from 2.99% and with one month trail. Contact us today on +1-281-857-6354

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