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How to Overcome RCM Challenges Faced by Small Practices?

Revenue cycle management is the financial procedure that involves keeping patients data form appointment and registration dates to clearing bills using medical billing services for small practices as well as the large ones. Inadequate billing procedures can result in a loss of capital as well as jeopardize the ability to provide excellent care. Streamlining and improving the main management processes can help providers stay financially stable.

Challenges in Revenue Cycle Management

A hospital’s ability to provide innovative care depends on precise clinical paperwork and a clear communication between providers, payers, and patients to get timely reimbursement.  Here are some of the difficulties in managing the revenue cycle in medical billing services for small practices.

Revenue cycle management is an essential component for all practices and hospitals that helps in timely reimbursement. Here are some of the challenges in healthcare revenue cycle management:

Fulfil Compliance Standards:

Revenue cycle management requires to follow compliance standards and rules released by the Accountability Act 1996 (HIPAA) that bounds medical billing companies to keep patients’ information safe while clearing bills as it is their responsibility to protect patients’ data confidentiality, security, and privacy.


No information exchange between different organizations can result in a loss of time and increased medical costs for the doctor. Medical billing services interoperability refers to a company’s ability to freely exchange data and information. Doctors should have easy access to their patients’ information and be able to easily integrate it with other systems.

Payments to Patients

Receiving patient payments is one of the most unavoidable revenue cycle challenges that small practice providers face. With the rise of high-deductible plans in the United States, providers are struggling to make ends. Patients are no longer budgeting for medical expenses in the same way that they would with a low deductive plan. Every small practice is confronted with this revenue cycle challenge.

Trained Staff:

Every practitioner needs trained staff to streamline medical billing and make the cash flow process smooth. If the employees are not trained enough to manage medical billing and revenue cycle, the entire practice will be in turmoil. All employees need to be expert, from recording data to billing, to keep the overall process smooth. Unskilled staff can do incorrect coding, miss the required information while entering patients’ data, incorrect billing, or any other mistakes. Employee training becomes mandatory to keep them work smoothly, increase ROI, and reduce turnover rates.

How Small Practices Can Maximize Their Revenue?

Apart from providing the best possible care to the patients, all physicians want to maximize their revenue and generate the most amount of net revenue possible. Unfortunately, coding compliance, claim denials, and rising technology costs make this goal difficult to achieve. On the other hand medical billing services for smaller practices can maximize their RCM and boost their bottom line with sound strategies.

Outsourcing medical billing services for small practices:

In general, running a small practice entails forming close bonds with your patients and their families. As a result, there are frequently past-due balances and collections that never occur. Outsourcing medical billing services for smaller practice allows you to maintain a close relationship with patients while also receiving payment. Medical billing services for small practices also frees up time for your staff to focus on other aspects of your practice.

Regardless of changes in the healthcare industry, maximizing your small practice’s revenue cycle is within your control, even if it doesn’t always feel like it. While utilizing tools such as EHR and practice Management (PMS) systems is critical, it is also important to get medical billing services for small practices to efficiently clear claims and receive payments.

Denial Management

Managing claims denials effectively is an important part of maximizing revenue. Your employees must be proactive and diligent in order to accomplish this. For example, training your staff to verify insurance eligibility at check-in is an important front-end strategy for reducing denials. It’s critical to develop processes to track denials as they arrive on the back end. Give importance to the small claim amount as collectively those claims can become large and cause revenue leakage.

Medical billing services for small practices prevent this revenue leakage as reputable companies give importance to each claim, scrub them, manage denials and process them for reimbursements.

Integrate EHR and Practice Management Software:

Many practices now manage their billing and accounts receivable using electronic practice management systems. Traditional methods of paper super bills submission is still in use but they are inefficient and prevents practices from maximizing revenue.

Providers can get additional benefit when their EHR and practice management systems are integrated as they speed up the process of review charges and submit claims. The end result will be faster reimbursements and higher-quality reporting, allowing practices to fully participate.

Consider Outsourcing:

Many healthcare organizations are having difficulty attracting and retaining employees with the skills required to navigate an increasingly complex billing procedure. A small practice can benefit from an RCM firm’s experience and technological support that will also increase ROI and efficiency.

If your small business has struggled through above mentioned challenges, BMB medical billing services for small practices might be a good fit. Medical practices recognize that revenue cycle management must be a top priority in order to provide high-quality patient care. Despite its complexity, outsourcing is one way to overcome the challenges of RCM and free up healthcare staff to focus on patients’ care.

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