A patient having insurance doesn’t always guarantee that the medical service that the hospital, clinic, or office provides will be shouldered in part or in full by the insurance company. There are rules that must be followed, paperwork to be filled and submitted, and schedules that must be kept. This is where revenue cycle management services (RCM) step in—to make sure hospitals and clinics get appropriate credit for each person they help.
Errors in the paperwork submitted to an insurance company can lead to delays in payment, even its outright denial. Most of the time, these errors start as early as data gathering. Normally, representatives are only given little time to get patient’s information and insurance coverage. If eligibility is not verified, rooming and medical procedures can be put on hold, which is problematic for everyone concerned.
This is when eligibility verification provided by a RCM system helps.
All over the country, outdated billing systems and missed charges are problems that persist in many medical facilities, often requiring the tedious task of going through the paperwork again just to track down where the error lies. The revenue cycle management process provides reliable automated functions to avoid this breakdown and minimize if not completely eliminate unpaid services.