Revenue cycling is about revenue management. It is the financial aspect of most medical firms to track patients’ episodes using billing software, starting from the appointment date to the final payment.
This process has helped healthcare organizations stay financially healthy while saving the lives of patients. Think of it as a value-based care reimbursement. The tracking process, however, is cumbersome. Hence, the outsourcing to RCM companies.
What Is A Revenue Cycle Company?
RCM companies (revenue cycle companies) are companies concerned with reconciling debt and payment of medical bills and; the billing process of a healthcare facility. They contact the patient’s insurance company on behalf of the health care organization to make claim.
There are several of these companies and choosing the top revenue cycle companies can be a real challenge. But there are things to look for when selecting one.
Factors To Select The Top Revenue Cycle Companies
Years of Operation
First things first, you need to know how long the company has been operational before hiring them. Infant RCM companies don’t have the needed experience to deal with certain claims. Top revenue cycle companies have been around for a while and they have the advantage of experience to get the job done.
The Company’s Certification
Regardless of how long the company has been in the practice, it must be certified. Your choice RCM company must be ISO 9001 certified as a symbol of the quality standard maintained by the company.
HIPAA Standard Compliance
Health Insurance Portability and Accountability Act (HIPAA) is an act that guarantees the protection of patients’ data. If you would outsource, you need the certainty that everything is confidential, especially the patient’s data. Only the top revenue cycle companies will comply with HIPAA.
Quality of Clientele
Another thing to look for when selecting a revenue cycle company is its clientele. How many clients do they get? What kind of clients do they get? The quality of their service will determine if their client will return. Also, be sure that you fall into the category of clientele they usually take on.
Management and Support Team
Top revenue cycle companies have a strong management and support team. This team is the heart of the company. They are always on their toes to get things done. It is important to know their qualification or experience in the field. The best RCM companies have qualified management and support teams.
Company’s Claim Ratio
The claim ratio here is the number of rejected and successful claims the company has made. Generally, most RCM companies aren’t forthright about this information. You need to discuss this information with them before hiring them. You need a company with more claim success track records than rejected claims.
Cost of Service
Another factor to consider when selecting an RCM company is its cost of service. Before making a choice, the company should be cost-effective. You shouldn’t sacrifice cost for value. Most times, we think the high cost is a disqualifying factor. But if the company is willing to deliver what you want within a budget, you should consider them. Top revenue cycle companies have made a name for themselves. Regardless of the cost, they will deliver quality.
Revenue cycle management is cumbersome, hence, outsourcing. However, one should only outsource to companies that deliver value. The above factors will help in selecting the top revenue cycle companies.