What Are the Biggest Problems of Physician Revenue Cycle Management?

2 min

Physician revenue cycle management process helps individual practices and out-of-network physicians to get their revenues on time. This is an arduous process that needs meticulous attention. Most errors tend to happen during the billing and coding stage and managing this independently is an impossible task for physicians.

In this article, we focus on the challenges faced by physicians in managing their revenue cycle 

1. Keeping the Patient Informed

The patient must be kept updated about their financial obligations towards the medical services rendered to them. This is because, the chances of the patient paying their dues on time increases when they are educated about their balances, payment options, modes etc. They will have time to effectively plan and arrange cash to clear their dues. Therefore, the physician revenue cycle management staff must inform the patients about their estimated payment details to ensure timely reimbursements.

2. Providing Various Payment Modes

This is a big challenge faced by most physicians. It can be overcome by incorporating software which allows the patients to pay through various modes. These modes of payment can range from online portals, phone payments, credit, debit etc. Those private practices that do not provide different payment options for their patients might lose out on opportunities to get reimbursed quickly.

3. Managing Claim Denials

Claim submission is one of the final steps of the physician revenue cycle management process. Ensuring error free submission is the biggest challenge of this process. Also, as it is time consuming it must be completed within set deadlines. To overcome this challenge, the medical billers and coders need to verify the patient and medical information collected. They need to carryout multiple quality checks to ensure clean claims while submitting them to the insurance provider.  If any claim denials occur, the errors must be identified, corrected and resubmitted within the given deadlines.

4. Handling Multiple Claims

An increase in number of patients causes an increase in the number of claims to be filed. Handling multiple claims gets challenging for the physician billing staff, thereby impacting their medical revenues. Using claim submission software can simplify the process of filing multiple claims. This way, they do not face the problem of stacking and delaying claim submissions, causing them to lose out on timely revenues.

5. Incompatible Software

Each private practice has unique requirements and would need a tailor-made software to ensure compatibility. Finding a software that is a right fit is challenging which is why some private practices invest on software that do not suit all their requirements. Also, if a software is not customizable, implementation of any new features will get difficult. These compromises can lead to undesirable results. To overcome this challenge, it is important to invest on a customizable software strictly in keeping with a physician’s requirements.

Since private practices are run by individual physicians, their revenue inflow gets affected when these problems are left un-checked. revenue cycle management companies can assist physicians tackle all these challenges. They guarantee regular inflow of revenue and help physicians focus on their individual practice.

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