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What is the Normal Revenue Cycle?

What is the Normal Revenue Cycle?

What is the Normal Revenue Cycle?

While doctors would usually prefer to focus on the level of care that their patients are receiving, it is important that they also understand their practice’s revenue cycle. It is only possible to isolate problems within a practice’s revenue cycle when the whole picture is clearly understood. Working with a competent medical billing service is crucial to arriving at the figures that you need. 


Patient Registration

A patient enters the revenue cycle when they receive their first appointment. One of the largest problems that doctors and other medical providers encounter at this step is that incorrect patient information is received. Then, insurance companies refuse to pay the claims believing that they are not legitimate. Denials need to be monitored daily allowing paperwork to be resubmitted as soon as possible. If you notice that one individual is making most of your errors, then you may need to do some retraining. In order to maximize your revenue stream, make sure that patients are entered into a system as efficiently as possible and that each member of the team knows their job duties. 


Medical Coding

Before the visit, it is crucial that the correct medical codes be submitted to insurance companies for preapproval. This allows them to process the request sooner, so you will get your money sooner. Understanding the different codes available allows you to maximize which codes you are using. In turn, you can increase your revenues while still staying within guidelines established by law. 


During the Visit

Clerical personnel working for the medical practice need to make sure that they are collecting the right amount of copay during a patient’s visit. If payment arrangements are made with patients, then they need to be gone over with the patient and signatures obtained. This ensures that the provider can come back later and process those claims. While it may not seem like it cost much money to send paper invoices, emails, and other billing materials after a patient has seen a provider, many practices find that the cost of doing this is much higher than they imagined when this cost is isolated.


Billing and Collections

The next step is billing and collections. Normally, the first step is to get the claim submitted to the insurance company. Consider using a third-party system to make sure that claims are submitted cleanly. Any claims that are denied should be gone over daily to ensure that they are resubmitted as quickly as possible. Consider these denials as a whole to see if changes need to be made in your medical billing services. Many practices put off doing claims until the end of the week. This is a bad idea because claims can be lost during the week. The most successful practices take the time to submit claims daily.


If you are ready to take the financial side of your medical practice to a new level of excellence, contact Signature RCM. Their innovative revenue cycle management services will help you succeed.