Revenue Cycle Management Services RCM (Billing Services)

Revenue Cycle Management Services RCM (Billing Services)

Revenue Cycle Management or RCM is a professionally monitored process designed to collect payment for services rendered by private practitioners ,especially Behavior Analysts, behavior therapists, and other providers in the healthcare sectors. Our goal is to help you focus on providing the highest level of care to your patients or clients, without having to lose countless hours trying to collect payment.

RCM billing services represent a broad move in the healthcare industry toward value-based reimbursement without the risk of financial loss due to poor billing practices. It’s quickly becoming a key component to help private practices maintain efficient services and financial viability.

Identifying RCM Challenges

There are several steps in the RCM process from patient pre-registration through filing claims and receiving final payment. A typical revenue cycle starts when a patient schedules an appointment and is completed when payment for those eventual services is collected. Of course, each of the steps in the process needs to be completed efficiently to minimize loss and maximize your practice’s efficiency.

We help maximize your practices potential by

  • Communicating effectively and efficiently

  • Identifying and correcting coding issues

  • Identifying and correcting medical billing errors

  • Rectifying simple human error when entering information

Add to this the constantly evolving landscape of healthcare regulations, managing your staff, or other necessary resources, and you are faced with several different challenges. Unfortunately, hiring additional administrative staff isn’t always the most efficient option. Yet most practitioners find they don’t necessarily have the training to tackle billing and collection tasks on their own. Especially if there is a problem with an insurance claims or a request for an audit.

You can focus on things like:

  • Increasing patient volume

  • Providing intensive services

  • Increasing overall productivity

  • Expanding the scope of your practice’s service

  • Focusing on what matters most: Your patient’s making progress.

Professional RCM Services Help With Payment Collection

Non-payment for services rendered is one of the biggest areas of loss for private practices. Especially for Behavior Analysts and behavior therapists, who have other more important things to focus on. As our professionals have learned, non-payment can be linked to several different things including high deductibles, lapses in insurance coverage, or patient unawareness of their financial responsibilities.

Benefit Check Pre-Registration

Operant Billing Solution’s RCM process starts with “Patient Pre-Registration” which helps your potential patients to accurately understand their responsibilities. It’s also an effective way to collect insurance and medical history information from new patients. The pre-registration phase is also a great way to spot potential problems with insurance coverage and identify limitations such as a policy’s maximum allowable visits within a particular coverage plan.  

Digital Data Review

We spot the data issues that can cause holdups before there is a problem. Inefficient data collection poses a serious threat to the long-term success of any RCM cycle. A vigorous, professionally monitored data process helps keep workflow, coding, and communication seamless, while also eliminating the common problems that occur with paper documentation.Our team has the “sharp-eye” experience, diligently checking for any discrepancy before reimbursement submission claims, significantly cutting down the time it takes for you to get paid.

Identifying And Dealing With Eligibility Issues

Efficient communications with health insurance companies is a critical component of the RCM process. Problems in this area of the process can lead to problems with pending, rejected, lost, or denied claims. Identifying eligibility issues also helps with tracking claims and accelerating the claims payment process.

Reducing Fragmented Administrative Issues

Information flow throughout a private practice can be a challenge, which sometimes leads to fragmented administrative issues such as:

  • Inaccurate or missing information during the patient intake.
  • Misunderstanding a patient’s coverage eligibility.
  • Lack of payer coordination between primary, secondary and/or tertiary insurance coverage.
  • Delayed or lapsing claims reimbursement.

Being able to outsource these tasks to a professional service like Operant Billing Solutions, keeps the information flowing seamlessly throughout all administrative aspects of the RCM process. It also helps to catch gaps in a patient’s coverage to ensure that you, the practitioner aren’t left hanging with a denied claim weeks or maybe months down the road.

We’re Your Outsourced Administrative Staff

At Operant Billing Solutions our administrative staff are knowledgeable, highly trained, and experienced in all aspects of the RCM process, as well as the specific needs of private medical practitioners.

Our administrative staff can play a vital role in collecting revenue and improving your practice’s efficiency. Along the way we foster collaboration with your in-house staff and contribute to the long-term success of your private practice.

Many private practice providers invest in healthcare Revenue Cycle Management software packages that employ Practice Management tools and features like EHR (Electronic Health Records). Though this does still leave you having to manage the RCM process from start to finish when you could otherwise be focusing on patient care or expanding your practice.

This type of RCM often struggles to be a stand-alone solution. At best it can be integrated with a professionally outsourced administrative service like Operant Billing Solutions to provide a seamless synergy that keeps your focus where it has the most value.

This includes:

  • Patient pre-registration

  • Patient tracking

  • Claims tracking

  • Eligibility determination

  • Insurance verification

  • Coding

  • Record-keeping

  • Billing practices

  • Payment collection

  • Patient responsibility

Other Special RCM Features

Patient tracking, insurance eligibility, and billing might make up the bulk of the RCM features that Operant Billing Solutions offers. Yet we do offer additional administrative services such as:

  • Automating duties such as payment reminders

  • Communicating with insurance companies regarding denied claims

  • Issuing prompts to your staff to enter or update patient and credentialing information

  • Streamlining the reimbursement for Medicare patients

  • Determining patient insurance status

  • Determining patient copay requirements

  • Error detection and correction

  • Tracking unpaid claims

  • Payment collection

  • Identifying potential revenue shortfalls

The RCM processing services offered by Operant Billing Solutions has helped propel a wide range of private health care practices, and behavioral therapists to expand their scope of care. We have experience working with:

All the while increasing revenue, improving client satisfaction rates, and patient volume. We spare you having to be hands-on with time-consuming administrative tasks. All at a cost that is less than if you were to invest in expanding your in-house staff.

We have the professionals, and infrastructure in place with the experience to take RCM and other administrative tasks out of your hands to let you grow your practice while focusing on your patients.