Strategizing to Overcome Volume Deficits and Maintain a Healthy Revenue Cycle in 2021

When it comes to revenue cycle management (RCM) — during COVID-19 or normal times — it’s important to remember some best practices, on the payer and patient side, that make groups profitable. Patients’ insurance eligibility should be verified before a claim goes out, ideally in real-time as patients are waiting or being treated. Practices can confirm demographic data, verify insurance, and even leverage it to generate price estimators based on their deductible, copay, and other payer information.

Practice administrators also should ensure that the practice posts all its payer denials accurately. Electronic payments, or electronic remittance advice (ERA), are vital to ensure the practice management system (PMS) is properly programmed to populate denial codes, especially for zero-pay ERAs accurately.

Once a group practice establishes that the denial information is captured accurately, it may be analyzed for a deeper understanding of denial trends.