Three-quarters of hospitals say they are facing a hostile revenue cycle influence. Even though post-pandemic revenue and other financial metrics have begun to climb up, the cost of inflation and the skyrocketing expenses of managing medical care for patients is offsetting the majority of income. So, how do you get your practice to optimize your revenue cycle? Coming to Gables Medical Billing and allowing our billing experts to manage your claims submissions, follow-ups, appeals, and payment postings is the best option. There are also a few ways that you can kick off a more efficient reimbursement process. For instance, you could start by submitting the cleanest claims. Ensuring that your claims are squeaky clean, correct, and contain complete information is essential to the health of your revenue and practice cash flow. Experts have been quoted as saying that providers need to work to get their clean claims rate to above 90%. Scrubbing claims, or using a medical billing and coding company, like GMB, is a great asset that could assure your claim is not going to get caught up in adjudication. Managing your denials in a more seamless manner is also going to be pivotal for your revenue cycle management. There’s a three-pronged approach that experts have touted which is to prevent the denial by scrubbing them in-house or using a clearinghouse. This would also mean that you are leveraging historical information on what the payers have denied and their reasoning for it. The second prong in this approach is to recover from the denial more quickly, this will mean that you are leveraging machine and artificial intelligence with automation methods. This step is extremely helpful when you’re dealing with a bulk of denials from a single-payer. The third part of the process touted by experts is escalation. You will need an escalation workflow for this process as well as highly qualified experts in revenue cycle management that understand the entirety of the claims management processes. No to toot our own horn, but Gables Medical Billing has outstanding medical billers that have a deep understanding of revenue cycle management and thorough knowledge of dealing with a wide variety of payers and receiving reimbursement in a timely manner for clients that work in varied medical practices and specialties. Bringing your billing to GMB means that we will handle all claims submissions, follow-ups, appeals, and payment posting with the same dedication you treat your patients.
