Get Live Chat Request a Callback Get live demo

← Back

What You’re Getting Wrong in Revenue Cycle Management (Part 2)

Revenue Cycle Management

In part one of this blog post we covered two important things you might be missing in your revenue cycle management. Here are two additional things to be aware of that could be causing you to lose out on revenue for your medical practice.

3: Assuming that revenue cycle management is done once you send a claim.

A common mistake that many providers and office managers make is assuming that your part of the revenue cycle ends when you send a claim for payment. While this often results in reimbursement by a payer, that is not a guarantee. The American Academy of Family Physicians (AAFP) reported that, on average, payers deny about 5% to 10% of claim submissions. A 2018 report from the Office of the Inspector General found that about 8% of Medicare Advantage claims are denied, while a Kaiser Family Foundation review of data reported by plans on the Affordable Care Act marketplace found that it can vary widely by payer, from 1% to as high as 40%.

Claims are denied for a variety of reasons. It could be as simple as missing information, an error in the insurance ID, or an incorrect Social Security number. In other cases a claim is denied because of a problem with coding or documentation, missing preauthorization, or the procedure isn’t covered by the patient’s plan.

A denied or rejected claim doesn’t always have to be written off. You can fix and resubmit claims with missing or incorrect information. You can also appeal claims denied for other reasons, but there is a deadline. That requires an adequate follow-up process to avoid leaving money on the table.

4: Not following up with patients for prompt payment.

Another common issue that could be negatively affecting your revenue cycle is a lack of follow-up with patients for outstanding balances. We know it’s difficult to talk about money, but it’s critical that you set an expectation with patients that they must promptly pay. Medical billing is complicated; you provide a service upfront and then have to bill for payment at a later time, which can lead to non-payment or late payments.

Some things that can improve your total patient collections include:

  • Providing an up-front estimate of the cost of a visit or procedure to set patient expectations. A 2016 survey found that 70 percent of patients who get an estimate are more likely to pay their bill.
  • Sending timely and frequent reminders via email, text, and mail to collect on unpaid invoices.
  • Offering flexible payment plans up front to help patients who might have otherwise ignored your invoice to pay it in small installments instead. If your current medical billing software doesn’t allow for payment plans, AdvancedMD can help.
  • Including a simple option for online bill pay with every text, email, or mailed statement.

Improve Your RCM Today

If your RCM isn’t cutting it, talk to AdvancedMD to find out more about our extensive suite of revenue cycle management software that can help you get things back on track.

Topic: Revenue Cycle Management

Other Resources Related to This Topic

Medical Billing

Why Choose an AdvancedMD Billing Services Partner?

Grow your practice with expert medical billing services from a premier AdvancedMD RCM partner. Explore...

Medical Billing

In-house & RCM Comparison

Flexible Billing Options for All Stages of Your Practice When considering how to manage your...

Medical Billing

RCM Overview Video

Watch this 1:41 video for a high-level overview of our RCM services bundle, including medical...

“The money I have invested in AdvancedMD is miniscule compared to the return. I have never been more efficient – ever – in my professional life as I am now.”

Jed Shay, MD
The Pain Care Center

Read the story  ›

“[Our] patients are very well-educated and well-informed, and they want to see results quickly. The practice has to run extremely efficiently and be accessible to them. The nice thing about [AdvancedMD] is it has allowed me to be more efficient both in and out of the office. Now I don’t have to come back into the office, which is great for my family and everything else. It saves me a lot of time – probably an hour a day on the three days I work in the second office.”

Keith Berkowitz, MD
Center for Balanced Health

Read the story  ›
Estaban Lavato, MD - La Loma Medical Center

“The best thing I ever did in private practice was getting AdvancedMD—it has liberated me.”

Estaban Lavato, MD
La Loma Medical Center

“Having integrated practice management and EHR is absolutely wonderful, you don’t have to flip back and forth between systems—all of your information is at hand when needed.”

Raju Raval, MD

Read the story  ›