What is Revenue Cycle Management (RCM)?
Revenue Cycle Management (RCM) is the process of tracking the entire financial life cycle of patient care, from initial intake to collecting payments or offboarding. In the world of home care, RCM is a multi-step process that ensures agencies get paid on time and in full.
First, agencies must register each new patient in their client management system. Then, they need to conduct the necessary insurance verification, send invoices for services rendered, process insurance claims, receive payments, and if necessary, send delinquent bills to collections. All the while, it’s also important to bolster your financial health with supporting optimization efforts, like proper scheduling and business analytics.
Given the complexity of billing cycle management in the home care space, RCM tools are essential for agencies to maintain their financial stability. With so many insurance players involved, including Medicare, Medicaid, and private vendors, things can get complicated fast – so it’s essential to simplify and automate as many touch points as possible.
When executed properly, RCM can greatly reduce human error when inputting financial information, which in turn cuts down on claim denials and payment delays. It also enables more airtight compliance, faster payment cycles, and improved cash flows. Read on to understand the five main pillars of an RCM strategy and how they work together to increase operational efficiency.
1. Optimize Billing Process
An automation-focused home care billing software makes it easy to create, submit, and track claims and payments for services provided. It also ties all of that information together to create accurate reports that help agencies track their financial performance while identifying areas for improvement.
Taking the steps to streamline your billing process is a key component of optimizing your RCM, paving the way for increased accuracy and timeliness. Relying on software reduces the administrative burden placed on in-office staff as well as the opportunity for human error in one fell swoop, leaving agencies with complete and error-free information they can rely on.
2. Implement Electronic Visit Verification (EVV)
Electronic Visit Verification (EVV) systems track caregiver visits from start to finish, acting as an accountability system for all parties involved. Home care staff clock in at the beginning of an appointment, record the details of their visit, then clock out once they have completed their responsibilities. All the while, the EVV system ensures all the necessary services are provided to every patient, and that caregivers are properly compensated for the time spent during each session. Mobile app integrations play a major role in enabling EVV in the home care space, allowing caregivers to record visit information in real time while they are on the road.
By verifying the time and location of care provided, EVV helps reduce billing discrepancies and errors. It also enhances compliance with state-specific Medicaid requirements, leading to more timely and accurate reimbursements.
3. Use Scheduling Software to Utilize Staff Time & Visits
If time is money, home care scheduling software is the ultimate savings plan. These platforms automate the entire scheduling process, assigning the right caregivers to the right patients at the right time. It optimizes based on clients’ needs, practitioners’ specializations, distance between appointments, and any other preferences outlined by either party.
This means resources will always be allocated efficiently, fitting as many visits as possible into each caregiver shift while still respecting preferred hours and minimizing time stuck in traffic. Not only will staff be more satisfied and less prone to burnout, but automated scheduling reduces operational costs by way of avoiding missed appointments and instantly allocating a new caregiver to any empty slots.
4. Invest in Staff Training & Development
Implementing and maintaining a new system is never easy – but there are certainly ways for agencies to stack the odds in their favor. Providing robust training right from the jump ensures admin staff will understand how to make the most of their new RCM software; properly demonstrating how the system will make their work simpler and easier is a surefire way to get their buy-in.
Of course, training isn’t a one-and-done deal. As new regulations and best practices come to light, staff should receive ongoing education to better manage billing processes, reduce errors, and improve overall revenue collection.
5. Leverage Technology for Revenue Cycle Analytics
Once a new system is implemented, it’s important to understand whether it’s operating at peak effectiveness. Business intelligence tools track key performance indicators such as days in accounts receivable (AR), claim denial rates, and collection rates, giving agencies granular insights into the health of their billing cycle.
Over time, this technology will have collected enough empirical data to predict cash flow trends, irregularities, and continuously optimize the revenue cycle process.
Optimize Your Agency’s Revenue Cycle Management With AxisCare
We won’t sugarcoat it: revenue cycle management can be complex. That’s why AxisCare is designed to optimize every stage of the process under a single digital roof, with an intuitive user interface that simplifies each step as much as possible.
Request a live demo to learn more about how we help home care agencies save money, boost caregiver satisfaction, deliver outstanding patient care, and why we’re rated #1 on the platforms that matter most.
