RCM tip of the day: Monitor payer correspondence

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Hospitals and health systems can improve their revenue cycle and help assure proper reimbursement by focusing on payer correspondence, according to John Carter, senior vice president of revenue cycle management at Ability Network.

Mr. Carter shared the following tip with Becker's Hospital Review.

"Providers need to understand that each communication related to claims management — either directly or indirectly — has the potential to impact the revenue cycle. For example, certain payers will send regulatory notices and edit change notifications as a cover letter to a paper remittance. Since remittances are sent directly to an accounts receivable clerk, patient access and billing departments often miss important information included on the cover letter about the rule changes. It is important to also know where all communications are coming into your organization, and who receives and/or manages them. Managing payer correspondence is especially problematic for organizations that manage their claims and eligibility manually or use disparate systems.

"Once you've identified the communications coming in and who handles them within the organization, you need to ensure that the right communication reaches the right person in a timely way. While some organizations struggle with manual processes around this, technology can help with managing claims-related communications, ensuring the information reaches the right people efficiently. RCM workflow software that effectively tracks and manages claims communication can help ensure you are acting on the most timely and correct information to optimize your revenue cycle. RCM software can help reduce the manual and cumbersome job of passing information between departments, and avoid the gaps and misses that come from this information flowing through people versus processes, and most importantly, it helps reduce errors and omissions that can slow your revenue cycle down or increase denials."

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series. 



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