Denial management is an important aspect of healthcare as it delves into why claims are being rejected and enables practices to take the right action before it’s too late. The good news is that RCM processes can be fortified by recognizing any issues beforehand for the cycle to run smoothly and give medical practices the right profits.
How common is the issue of claims denial and rejection?
The American Academy of Family Physicians (AAFP) report, revealed that claims rejections in the healthcare industry have an average between 5-10%. Claim denial and rejection is one of the major financial trials faced by every hospital system which can be caused by the minutest of coding errors. To avoid such billing errors clinics deploy a Revenue Cycle Management (RCM) Software system.
4 Strategies to prevent claims denial and rejection with Revenue Cycle Management Software
According to a 2014 Advisory Board study, 90% of claims denial can be easily prevented by making a few alterations in the way claims are handled and this is linked to effective management of the Revenue Cycle Management process.
- Prevention- It is advised that the financial management should be focused on preventing claims denial to avoid managing denials later. The management should consider different ways in which RCM can be optimized to reduce any probability of financial errors.
- Automation- Automation and digital workflow can save time and money by reducing administrative costs. Practices can deploy a Revenue Cycle Management (RCM) software system to reduce manual errors and enhance workflow efficiency by identifying improvement opportunities across the revenue cycle which can ultimately give you fruitful financial gains. By automation, claims processing can be optimized and greater revenue can be captured.
- Analytics and Reporting – RCM software offers powerful reporting and analytics features that give information on the performance of claims. To implement corrective measures, providers might examine information to find common causes of rejections.
- EDI Integration – For electronic communication between healthcare providers and payers, the Revenue Cycle Management Software system frequently supports EDI. Data interchange is streamlined by EDI integration, lowering the possibility of errors that could result in claim denials.
Final Takeaway
If your medical practice hasn’t automated its financial processes then they should not wait out. Make sure that when you make your final software purchase it is ONC-ATCB certified. The RCM Software vendor should offer the right features and tools such as; claims management, claim scrubbing, compliance with ICD-10, processing of medical payments, and accounts receivable management. Software technology solutions help to support the smooth running of revenue cycle management processes which can get practices faster payments and improve overall workflow efficiency.
