Outsourcing Hospice Revenue Cycle Management Services
The article talks about Outsourcing Hospice Revenue Cycle Management Services.
Hospice care is a specialized form of healthcare that focuses on providing care and support for patients. Hospice care can either be offered in specialized hospice facilities, nursing homes or dedicated facilities or programs that offer a range of services to address the particular needs and well-being of qualified patients. These services are delivered by a specialized team of healthcare professionals, including physicians, nurses, counselors, and aides.
The primary goal of hospice care is to manage pain and symptoms effectively, ensuring that patients are as comfortable as possible.
Providing medical (specialized medical interventions, including pain and symptom management, symptom control, and medication administration) and palliative care as well as assistance with advance care planning requires a huge responsibility for hospices.
Running a hospice facility comes with numerous challenges, and managing the revenue cycle shouldn’t be one of them. Considering the level of care required for caring for patients, the complexities of revenue cycle management can often become overwhelming.
The solution lies in outsourcing this critical function to a specialized partner who can improve hospice revenue cycle management operations.
To manage patients’ needs effectively, and ensure that patients are as comfortable as possible, and that patients receive the necessary support, hospices can outsource administrative support in the form of revenue cycle management functions.
Outsourcing Hospice Revenue Cycle Management Services involves partnering with a third-party organization, often called a revenue cycle management outsourcing provider, to handle the billing, coding, and collection processes on behalf of the hospice provider.
Outsourcing hospice revenue cycle management helps ensure that patients can access the comprehensive services offered by hospices without incurring significant financial burden. Aside from optimizing your financial performance, streamlining operations, and allowing you to focus on patient care, outsourcing hospice revenue cycle management offers several other benefits.
In this blog, we explore the compelling benefits of outsourcing hospice revenue cycle management and how it can provide financial success.
These key points provide a solid foundation for understanding the concept of outsourcing hospice revenue cycle management.
Functions in Hospice Revenue Cycle Management Outsourcing
Medical Billing and Coding
Accounting and collections are not the specialty of healthcare practitioners yet are equally important in day-to-day operations.
If your practice needs help improving the accounting and collections process, healthcare outsourcing, particularly outsourcing medical billing and coding, is a great way to start.
Outsourcing medical billing and coding lets you work with Medical Billing Specialists who can be assigned to tasks such as provide correct posting for all credit cards/checks and cash payments and provide A/R month end closing among others. The tasks can also extend to participating in all quality assessment activities and assist to collect and analyze all information and recommend required improvements to all processes.
Medical coding is also important in the medical billing process. These codes are subject to changes or updates in the system. Proper entry of codes is needed to ensure proper documentation and collection.
Common causes of billing errors are incorrect entry of these medical codes, another cause is incorrect codes used result in higher payment amount for the services rendered. Healthcare outsourcing is a great way to avoid these kinds of errors in medical coding and make sure the patient is billed properly.
Insurance Verification
One specialized service in Healthcare outsourcing is to assign the process of reviewing and checking a patient’s insurance plan’s coverage and regularly updating and monitoring of the patient’s basic information and electronic medical records.
Healthcare outsourcing providers verify and review a patient’s insurance claims on a daily basis for accuracy.
Medical Transcription
Through healthcare outsourcing you can also work with staff with attention to detail and active listening skills to provide effective and accurate record transcription for patients and doctors’ records.
Medical Transcriptionists provide documentation support by transcribing medical reports, doctors’ notes, patient data. They provide effective and accurate patient record transcription, verify data entered from the claim form is accurate and complete to enable the claim to be processed correctly and accurately. They can also virtually scribe for surgeons, review notes for completion and fax completed these completed notes.
Telehealth Services
Telehealth services can be provided by outsourced staff with specializations to help practices improve their healthcare operations.
For example, by outsourcing healthcare services to Virtual Optometrists and Virtual Nurses, practices assign functions to well-trained professionals who are able to give the best care with little supervision. They work with a variety of patients and can conduct patient assessments and virtual check-ins prior to each scheduled visit onsite, patient intakes and reviewing of previous records, and brief patients prior to the procedure.
They can be asked to answer all basic medical questions and issues about the procedure apart from cost, as well as calls calling patients to verify information, calling MD offices, assigning faxes and sending receipt of referrals, answering calls from patients about refills. They also assist with taking calls from other optometrists about basic pre/ post op care. Their duty includes tasks like creating and maintaining accurate patient records, administering medication and monitoring for side effects, recording vital signs, and reporting symptoms and changes in patient conditions.
This ensures the recovery of patients and dramatically improves the turnaround time and wait times.
Inbound and Outbound Customer Service Support
Through Healthcare Outsourcing, you get to work with Inbound and Outbound Customer Service specialists who can be primarily tasked to assist patients in preferred communication channels such as calls, emails, messaging and walk through patients on the terms of service, insurance coverage, and payment options.
They also assist patients on their scheduled appointments or treatments and consultations. They maintain the customer database and talk to and reach out to patients on their claims status and records, incoming appointment requests and status, and confirm, cancel or reschedule appointment requests.
Inbound and Outbound Customer Service specialists have excellent interpersonal skills, active listening and customer-care with focus on quality, problem solving, and analyzing information, and documentation skills.
Why outsource Hospice Revenue Cycle Management Services?
Revenue cycle management requires comprehensive knowledge of the hospice industry, as well as its guidelines and regulations.
The process of revenue cycle management involves managing the financial aspects of a hospice facility, including billing for medical treatments, medications, and other services provided, such as claims processing, and payment collection. Outsourcing lets you assign specialized tasks covered in the entire revenue cycle.
When you outsource Hospice Revenue Cycle Management, you work with a provider that specializes in medical billing and coding managing inquiries, and facilitating collections to improve cash flow. By outsourcing to a reputable partner, you gain access to a team of healthcare professionals with relevant experience in hospice billing, coding, and collections.
Managing revenue cycles internally can be time-consuming and prone to errors, which can lead to delayed payments and denied claims.
Outsourcing the Hospice Revenue Cycle Management function lets you improve financial operations by hiring outsourced staff to handle time-consuming claim submissions to insurance payers, tracking of claims, and following up on any denials or delays, thus ensuring timely reimbursement.
You can also expect accurate coding and thorough documentation, crucial for proper reimbursement. RCM outsourcing providers ensure data entry in medical records, codes, compliant with coding guidelines. This helps ensure that patients can access the comprehensive services offered by hospices, analyzing claims to avoid and/or resolve claim denials, reducing the likelihood of revenue loss.
Aside from timely reimbursement of payments, Hospice Revenue Cycle Management Service Outsourcing providers ensure compliance with changing regulations and maximizing reimbursement by staying up to date with industry standards, latest regulations and coding guidelines. Security measures for the protection patient data and compliance with healthcare privacy regulations, such as HIPAA, are observed.
Outsourcing Hospice Revenue Cycle Management involves navigating complex reimbursement rules, multiple payers, private insurance plans and varying coverage criteria and most private insurance plans. Providers can assist with contract negotiations with payers to optimize reimbursement rates and terms.
Considerations when choosing a Hospice Revenue Cycle Management Service Provider
When considering a Hospice Revenue Cycle Management Service Provider, it is important to evaluate the financial implications and potential return on investment. The cost of outsourcing Hospice Revenue Cycle Management varies based on the size of the hospice provider, services required, and the chosen Hospice Revenue Cycle Management outsourcing company.
Second, when outsourcing Hospice Revenue Cycle Management, a formal contract should be established, clearly defining the scope of services, responsibilities, performance metrics, data ownership, and termination provisions.
It is crucial to thoroughly evaluate Hospice Revenue Cycle Management outsourcing companies, considering their experience, reputation, client feedback, technology capabilities, scalability, and flexibility.
In summary, a hospice is a specialized healthcare approach offers a comprehensive range of services delivered by a multidisciplinary team, aiming to provide administrative support in a hospice care facility. To help address the medical and palliative care of a patient, outsourcing hospice revenue cycle management helps ensure that patients can access the comprehensive services offered by hospices without incurring significant financial burden.
Outsourcing lets you ensure improved financial operations, such as accurate and compliant billing, reduced claim denials, coding, and collection processes, ensuring accuracy, compliance, and timely and maximum reimbursement for your services. Additionally, outsourcing providers stay up-to-date with industry regulations and coding guidelines, reducing the risk of revenue loss and maintaining compliance with changing requirements. Aside from optimizing your financial performance, outsourcing lets you streamline operations, letting you to focus on patient care.
When considering outsourcing, it is important to evaluate the financial implications, establish a clear contract, and select a reputable provider with the necessary expertise and technology capabilities.
Elevate your hospice’s financial performance by exploring our blog post on top outsourcing services. Learn how strategic outsourcing can streamline your revenue cycle management.
Connext Global Solutions provides Healthcare Outsourcing for healthcare and hospice organizations. Outsource Healthcare services to Connext today
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Discover how regulatory shifts affect healthcare financial management. Visit our blog for an in-depth look at the impact of regulatory changes on dental revenue cycle management, enhancing your understanding of outsourcing services in similar healthcare sectors like hospice management.
