A revenue cycle is an intricate set of stages, each with unique dependencies and nuances. Understanding the revenue cycle from patient visit to payment received can help your physician group or practice maximize profit and increase efficiency. A streamlined and efficient revenue cycle enhances patient experience and slashes overhead time and cost.
The first stage in the healthcare revenue cycle bridges the gap between scheduling and admission. This stage, although seemingly minor, requires a large collection of information from patients. Therefore, this stage has a major impact on the entirety of the cycle. During this stage, a physician group or practice gathers all demographic details such as patient name, address, date of birth and sometimes social security number.
Once the demographic information is completed and verified, the organization then collects the patient’s insurance information. When insurance is collected and inputted, the organization should review insurance covers, the deductible, or co-payment with the new patient. When the pre-registration is performed correctly, the organization decreases the likelihood of a claims denial based on inaccurate demographic information.
When the patient arrives, the next step in the revenue cycle begins. The patient fills out several forms to verify their identity, chart their medical history, and give insurance information. Though this step may seem redundant, it confirms all demographic, clinical, and insurance information is correct and up to date. Mistakes in this second stage can put your healthcare organization at risk of being audited or not receiving payment for services. This critical step in the revenue cycle protects both your organization and the patient.
Capturing Charges and Converting it into a Billable Invoice
When you outsource your revenue cycle management with MEDSTAT, we manage this step for you. With our automated technologies, we obtain charges from the visit and code the services that were rendered to the patient. After the appointment, we then convert clinical information and codes into a billable invoice and prepare the claim to be submitted to the payors. When MEDSTAT manages this step, your organization can spend less time worrying about coding errors or absent charges and more time focusing on the patient experience. Ultimately, our seamless charge process can help your practice receive payment faster.
Submitting the Claim
Claim scrubbing is the 4th and one of the most critical stages of the revenue cycle. Partnering with MEDSTAT for this stage can help your practice or physician group catch all errors before they are sent off to insurance. Our claim scrubbing process ensures claim denials are little to none. Once all charges have been entered and scrubbed, we then forward claims to the insurance carrier.
Remittance processing can be the most tedious of the revenue cycle stages. This step essentially explains the payments and is normally electronically posted. When payments are posted, they must be reviewed and processed. This step requires your organization to analyze several things such as allowable, fee schedules, and write-offs.
Finally, after you have made it through all these stages it is time for your company to receive payment. Obtaining payment can be difficult but by partnering with MEDSTAT, your practice is more likely to get paid in full and on time. Our intelligent healthcare patient engagement platform, iConnect, reaches patients more effectively and collects payments faster.
Team up with MEDSTAT
The expert team at MEDSTAT has served Arizona’s physicians for over 25 years. Partner with us to ensure that you are getting the most out of your healthcare organization’s revenue cycle. Get in touch with our team today to start streamlining your revenue cycle or to request a demo for our patient engagement platform, iConnect.