What RCM Billing Services Do You Actually Need?

The only thing more critical to a medical practice than its doctor is its billing service. Without the ability to submit bills, issue invoices, collect payments and statements, and communicate with patients, practices can’t stay afloat. Choosing a revenue cycle management (RCM) company with the tools needed to succeed is paramount.

Practices often choose a healthcare billing company without reviewing important considerations, resulting in costly upsells and/or underperformance from their billing partner. Let’s take a look at some of the major factors in choosing the right billing company for your practice.

What to Look for in a Billing Company

Authorization Management

Authorization management is a critical component of the billing process. It helps practices prevent denied claims by making sure the patient’s insurance approves the service before proceeding with treatment. Medical practices rely on pre-authorizations to ensure they’re paid for services rendered to patients, but many practices can fall behind on this process.
Failing to execute proper authorization management can land medical practices in trouble with both the insurance companies and their patients. Inaccurate claim submissions can lead to denials, which can cause a loss of revenue for the practice. If a claim is rejected due to no authorization, it will be returned to the provider.

Managing authorizations is an important part of RCM because it allows providers to improve cash flow and avoid a variety of penalties, but it can make it harder to run the practice. It’s time-consuming and can keep staff from their other duties and take away from patient care time. A good medical billing company can handle this process instead of placing the burden on providers.

Make Credentialing More Efficient

Credentialing is a time-consuming and painful process that every professional must undergo to get their job done. The result of this can be seen in the amount of time it takes for practices to hire new medical professionals. It’s no wonder that many practices are reporting a shortage of physicians. What’s more, it can take more time for them to get up to speed and start producing revenue for your practice.

Using an RCM service can help alleviate some of the burden associated with credentialing, particularly in terms of:

• Efficiency: The credentialing process is complex and requires many parties to work together. An RCM service can help streamline this process so that it’s completed faster.
• Security: Credentialing involves sending sensitive information over email, fax, or regular mail — all of which are susceptible to cyberattacks or theft. By using an RCM service, you can better ensure that all your information remains secure throughout the process.

Many organizations are turning to RCM services to help them manage their credentialing processes. Through an RCM billing service, you can ensure that the right people have access to the right information and that your organization’s data remains secure.

Rather than jumping through hoops to hire someone, using an RCM service can allow practices to promptly take care of all the paperwork and administrative tasks required by state laws and regulations. This makes it easier for them to hire people and get them up and running without worrying about whether they’re missing a step.

A credentialing service is also more efficient than having staff spend their time on administrative tasks such as filling out paperwork and making phone calls instead of treating patients.

Patient Payment Tools

TRIARQ understands the importance of value-based care. Custom-made financial management solutions can help providers manage and track patient payments, as well as identify opportunities to improve the financial performance of their practice. A billing partner can also help providers manage their accounts receivable, reduce the time they spend on collection calls and focus more on patient care.

The right partner should provide tools that are easy to use, compliant with state laws and regulations, and generate high-quality billable data. It should offer customer-oriented financing options to help providers attract new patients and retain existing ones. It should also offer strategic support, such as consulting services and business planning, to help providers navigate the changing healthcare landscape.

All this and more is available through TRIARQ’s own patient financing platform. It’s a compliant, secure, and scalable solution designed to help providers manage the financial aspects of their business.

Personalized Service Options

Different RCM billing services will have different features to choose from, so it’s important to look into the options available. Some companies will provide a more personalized service than others. They may offer customized reports and online access to billing data, which can help practices stay organized and on top of their finances.

VIP Access

A billing service with a large team, one that is experienced in the medical field and has access to a variety of resources, can typically offer more personalized services than a smaller operation. They’ll have team members standing by to take calls and address any concerns in a timely manner.

Medical practices shouldn’t have to wade through layer upon layer of customer service personnel to reach a decision maker. When there’s a crisis, healthcare providers need fast access to their partner’s senior executive team — not something that resembles a call center. A partner like TRIARQ can provide them with direct, immediate access to an executive with the power to resolve the issue as soon as possible.

Modern Technology

Another consideration is the type of medical billing system that a company uses. Some utilize an outdated, clunky program that can’t be accessed on mobile devices and takes a long time to process claims. Other billing services use cutting-edge technology that allows practices to submit claims directly from their phones and track payment status online.
TRIARQ, for instance, offers state-of-the-art revenue cycle management tools that integrate seamlessly with practices’ existing systems and accommodate many types of providers, including those just getting started.

The Right Way To Do Revenue Cycle Management

In the end, finding a medical billing company that can successfully bridge the technology gap, manage the relationship with payers, maintain data records, and submit accurate bills — all while meeting financial targets — is easier said than done. But the right RCM billing service is out there waiting to be found.

The experts at TRIARQ pride themselves on championing independent medical practices. Their revenue cycle management tools are particularly helpful to practices with small to mid-sized revenue cycles. Contact the team to learn more about TRIARQ’s approach.