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The Growing Importance of RCM

Posted by eClinicalWorks on 8/16/19, 12:45 PM

Why getting the finances right matters

Healthcare today is a mix of payment models, third-party payers, complex regulations, and codes. A practice’s survival depends upon getting the finances right. As getting paid appropriately and accurately for rendering medical services has grown more complex, so too has the importance of having an effective Revenue Cycle Management solution.

The 2018 CAQH Index® report found an 18% increase between 2017 and 2018 in the total volume of healthcare transactions across the U.S. Manual transactions declined 6%, evidence that practices and health systems are continuing to make progress in implementing electronic processing for coding, claims, and reimbursements.

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Unrealized savings opportunities

Still, practices as a whole are either not yet fully electronic or are unable to put to full use the depth and financial safeguards that a sophisticated RCM solution can offer.

“Continued efforts are needed to significantly reduce the volume of expensive, time-consuming manual transactions and adapt to the changing administrative needs of the healthcare system,” the report notes, adding that had fully electronic administrative transactions been in place, practices could have realized an additional $12.4 billion in savings in 2018.

An industry-leading RCM solution

eClinicalWorks remains one of the few healthcare IT companies that offers customers a choice of Revenue Cycle Management as a product or a service. Our account managers understand that erroneous, incomplete, or suboptimal coding can have a serious impact on a practice’s financial performance, and thus seek to understand each practice’s business, operational, and financial needs.

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Through eClinicalWorks’ products, practices can access intelligent, automated solutions, and gain full visibility of their finances. As a result, they are able to approach RCM challenges in a preventive and proactive manner.

Getting the RCM details right

At eClinicalWorks, we’re proud of our industry-leading 98%+ first-pass acceptance rate, a critical factor in helping practices reduce their accounts receivable and improve collections. But we understand that the changes in healthcare go beyond rapidly growing volume and complexity.

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There is today a patient-centered approach to every aspect of healthcare, including pressure from consumers for greater choice in how and where they receive care, knowing what insurance will cover, and how much they will pay for a given procedure.

That means that providers of all kinds need tools to improve transparency in their pricing and services.

Expanding to meet customers’ needs

At eClinicalWorks, our solution for ambulatory practices continues to grow in utility and sophistication. Our service team is expanding further into the retail side of our RCM business, helping customers make optimal use of our products.

We are also strengthening our vendor partnerships, with more clearinghouses, and a stronger system of alerts and appeals to ensure efficiency throughout the revenue cycle.

The RCM team now provides an evaluation of financial health for every retail customer — and each of their sites — to recommend how our products or service consultations could improve their bottom line.

For more information on how eClinicalWorks can meet your RCM needs, visit our RCM website, call us at (508) 836-2700.

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Topics: RCM, Electronic Health Records

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