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Christina Rosario

By: Christina Rosario on February 12th, 2020

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The Top Features of Revenue Cycle Management Software for 2020

Medical Billing / RCM

Your healthcare organization needs tighter control over the flow of revenue and you are now preparing to deploy Revenue Cycle Management software in 2020. If you’re new to RCM applications or are curious about how RCM will integrate into your company’s existing computation infrastructure, it pays to become more familiar with the software and how it works. To help guide you in the decision-making process, here are the top features to look for in Revenue Cycle Management software for 2020.

1. Available Via the Cloud

One of the best tools for you to consider when implementing revenue cycle management software is cloud computing. This takes the pressure off of your IT department since they will no longer have to predict how much server space or bandwidth is needed to access the RCM data. Your provider should offer you unrestricted, on-demand cloud access to all of your data 24 x 7 x 365 in order for it be worth installing the RCM.

A major benefit to keep in mind with cloud computing is that you can access your archived data even if there is a problem with your local computer systems. This brings peace of mind to healthcare organizations that fear losing patient information after computer hackers take over the network with malware, such as when criminals demand payments after a ransomware attack. 

Cloud computing is also beneficial because you can get up and running after a disaster, thanks to safe and secure online backups. When it comes time to expand your business, such as to add a satellite office, employees in the new venue will have easy access to your servers because of RCM in the cloud.

2. Complete Training

Verify with the software provider that they offer comprehensive RCM training on using the system for any functions you may want to perform. Usually, you will want to train your most knowledgeable and computer-savvy employees first since they will take less time to get up to speed and they can then help fill in gaps of knowledge with fellow workers after they’ve been trained.

An important note; you will want to start with a software demo to see if all the capabilities are present before you commit to ordering software and training materials (or training sessions). This saves you and the supplier a significant amount of time if the product being offered is not the right fit for your organization. 

3. Submit Claims at the Highest Value

Prudent office managers know that it is more efficient to work with an RCM that provides the ability to ensure claims are submitted at their highest possible value before being submitted. This is especially true when you are looking at potential reductions in reimbursements. 

It’s easier to rely on RCM software to keep track of the claims values – otherwise, proper payments might slip through the cracks and take longer for you to get properly reimbursed. It takes less staff time to do it this way, which further contributes to a positive bottom line.

4. Checking Eligibility

How much time do you estimate your staff spends on such routine tasks as verifying patient eligibility? This will be particularly problematic as we go into 2020 and you are helping patients who have now moved to Medicare Part C, a Medicare Advantage plan, or a Medicaid managed care plan. 

Your Revenue Cycle Management software will help with these eligibility inquiries, taking care of data transactions online. This saves time from when the staff would otherwise be hanging on the phone, waiting for a response from the patient’s provider. The RCM’s in-advance mechanisms are ideal for checking for prior authorizations. Many medical care providers use their RCM routinely to speed up generating estimates of patient responsibility amounts as well as to display co-payments quickly and efficiently. 

5. Claim Tracking and Correction

When a busy employee happens to make a typo or chooses the wrong code for a bill, you don’t want to wait an undue amount of time just to take care of the mistake. One of the best RCM features at your disposal will be the ability to track submitted claims in real-time and to check on their status. When a problem is detected, your employee will be given the opportunity in the RCM to quickly edit and resubmit any of these denials. 

6. Alerts for Denials

Of course, the best way to avoid denials in the first place is to set up your RCM with pro-active denial alerts. Each member of your team will now have the ability to re-code anything that’s been alerted. If an RCM cannot tell when data is incorrect, it slows down worker productivity and can impede the flow of revenue in your organization.

7. Key Performance Indicators and Reports

Preparation for the weekly meetings where staff gets together to go over reports will go much more smoothly and quickly when you set up your RCM to generate reports, including documentation for Protecting Access to Medicare Act, or PAMA, along with financial and managerial reports. You can also use revenue cycle management tools to develop and track key performance indicators or KPIs.

Find the Right RCM Software Solution for You

There is a lot of information to absorb when it comes to determining the appropriate revenue cycle management tools for your staff to work with. Your healthcare organization will function more efficiently when you take advantage of software that is designed with the latest in revenue cycle management capabilities.

Next Steps:

To learn more about using Revenue Cycle Management software, check out our article, “A Complete Walkthrough of the Healthcare Revenue Cycle Management Steps." There, you will learn how to apply our 7 step process, beginning with deploying RCM software or outsourcing the work to a third party. 

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About Christina Rosario

Christina Rosario is the Director of Sales and Marketing at Advanced Data Systems Corporation, a leading provider of healthcare IT solutions for medical practices and billing companies. When she's not helping ADS clients boost productivity and profitability, she can be found browsing travel websites, shopping in NYC, and spending time with her family.