Understanding the healthcare revenue cycle is integral to any physical therapy practice. When you understand what to expect from each stage in the cycle, you can optimize your process to move seamlessly from one stage to the next.
Our seasoned revenue cycle managers will help you do just that: manage your revenue cycle and optimize your processes accordingly. We’ll troubleshoot your existing processes, make some recommendations for improvement and monitor your practice’s performance to ensure that our suggestions are working properly.
The 7 Stages of the Health Care Revenue Cycle
Preregistration: A crucial step in the revenue cycle, the preregistration stage gives you a chance to capture important demographic and insurance information from your patient. During this stage, you’ll learn about the patient’s coverage costs and whether a referral is necessary.
- Registration: During registration, you’ll double-check the patient’s submitted information or collect any copayments. In states without direct access, you’ll need to check for referrals or prior authorization.
- Charge capture: This is the point at which the customer’s services are coded and their bill is drafted. EMR software can expedite this process, automatically processing, storing and transferring the patient’s information.
- Claim submission: Ideally, the claim is “scrubbed” for any errors before it’s sent to a clearing house that sends it to a payer. You should receive a transmission report that lets you know which of your claims were sent, returned, or dropped and why.
- Remittance processing: During remittance processing, you’ll receive a report that explains what you were paid for your services in comparison to the amount you charge. Analyzing your reports can help you troubleshoot avoidable problems in your billing process.
- Insurance follow-up: In this stage, you’ll identify any unpaid accounts receivable, including denied claims or partial payments. You may have to reopen claims to increase your reimbursement from the insurance company.
- Patient collections: This is when you collect copayments and deductibles from your patients. This stage involves collecting payments in person at your front desk and sending out billing statements to patients who owe.
Working With Insurance Providers
Our mastery of revenue cycle management speeds up patient payments as well as claims reviews from insurance companies.
Very few practices can speak to the breadth of knowledge we have working with insurers. Our long-standing experience in this area helps us maximize claims and reimbursements on your behalf.