How The Revenue Cycle Management In Medical Billing Can Benefit Your Plastic Surgery Practice?

 One of the most important factors in running a successful plastic surgery practice is managing the revenue cycle. With the evolution of technology in modern day healthcare, revenue cycle management or RCM ensures that the healthcare providers are properly and quickly reimbursed for their services. While this is certainly beneficial to the healthcare provider, it is equally beneficial to the patient. The revenue cycle begins as soon as a patient contacts the healthcare provider to make an appointment and ends when all payments for the appointment and treatment have been collected. The most important facet of revenue cycle management in medical billing is taking care of the obvious; the medical billing, the process of submitting health insurance claims on behalf of the patient to various health insurance companies in order to obtain payment for services rendered in a plastic surgery facility.

 

The immense amount of stress and revenue crisis the healthcare facility faces

In recent years, caregivers and their staff have been dealing with burnout in record numbers. The plastic and cosmetic surgery industry is no exception. Ever-changing laws, regulations and standards; health care reform and changing payment policies; too many administrative tasks; having little time for patient interactions, balancing with increased patient expectations, all kinds of obstacles. The COVID 19 pandemic has only exacerbated the situation. On average, the cosmetic surgery practices saw a decrease in turnover of at least 60-70% and a decrease in patient volume of 70%. To meet that challenge, healthcare providers first thought to optimize their revenue cycle through RCM (revenue cycle management).

 

Now, what is RCM in the field of cosmetic surgery practice?

In recent times, the medical billing system has undergone massive changes, several updates and new laws have been enforced with a conscious effort to streamline the process and bring all types of medical organizations under one branch. One should be aware of changes to surgical billing guidelines, insurance policies, recent code-related changes, and new government protocols. In addition, the healthcare income cycle consists of many steps, which means that there are many opportunities for errors. Any errors in the revenue cycle can delay provider reimbursement by insurers and patients or halt reimbursement altogether. The Modern Healthcare Revenue Cycle Management Services is a computer software solution that automates the entire healthcare billing process and incorporates all of the above features. The cycle starts with scheduling a surgical patient's appointment and ends when all payments for the appointment and treatment have been collected.

 

Different steps of revenue cycle management

a)    Appointment scheduling: - RCM starts with scheduling appointments for the surgical patients. Some of the best scheduling systems accurately display appointments and also show the time frame when the doctors are unavailable.

 

b)   Pre-authorization and eligibility verification of patients: - This is the second step that ensures that all new patients complete intake forms and provide insurance information over the phone, even before their first appointment. Updated in the software, it saves caregivers and patient’s time to discuss policies in the healthcare facility before their first appointment and the facility has time to review their insurance policy before the patient arrives. Revenue cycle management emphasizes completing this step accurately, even if a patient already has an account with the provider.

 

c)    Capturing the medical coding: - Insurance billing software converts patient services into billable claims using universally accepted medical codes. With these codes, insurers determine the reimbursements. Strong search capabilities help medical coders provide the most productive coding that dramatically reduces medical billing errors, accelerates the claim lifecycle and results in maximum reimbursements. HIPAA compliant RCM solution reduces coding and compliance risk and increases the profitability and efficiency of a cosmetic surgery care practice.

 

d)   Submission of insurance claim: - After a patient's treatment has been correctly coded, the claim is sent to the insurance company for approval. RCM makes sure this submission happens quickly by tracking and managing the claim from the start of the process. The RCM solutions authorize the verification of insurance claims and enable the billing agent and providers to process claims according to the requirements of other insurance companies. The software has another advantage: it creates an efficient internal analysis and audit report that can be created for unexpected assigned claims for patients.

 

e)    Collection of claim payment: - One of the key features of the RCM software. Once the patient's claim is approved, the insurance company will reimburse the provider based on the patient's eligibility. If there is any balance left after insurance reimbursement, the provider is responsible for reaching out to the patient to collect the remaining payment.

 

 

CosmetiSuite is an all-in-one EHR, practice management, and billing software built specifically for cosmetic surgery practices across the US. From us, you can be assured of the most efficient revenue cycle management in medical billing software solutions that will completely take care of the entire revenue cycle of your surgical healthcare facility to increase your profitability, reduce errors and accelerate reimbursement claims