Are RCM changes hampering physicians?
However, there are changes on the way that could have a major impact...
Revenue cycle management is what makes hospitals and clinics financially function.
However, there are changes on the way that could have a major impact on the medical billing process.
With financial health in mind, here are a few ways RCM changes could affect hospitals and physicians for the remainder of 2015:
RCM in health care
Many industries use revenue cycle management software to manage payment processes and the health care industry is no exception. Most hospitals use RCM software to handle revenue generation, payment, and claims processing information.
RELATED TOPIC: Should your hospital be considering an updated RCM system?
This allows health care providers to track billing cycles and quickly discover issues as they arise.
From ensuring payments are collected on time to taking care of denied claims, RCM software helps hospitals keep a continuous stream of revenue.
In addition to the functions above, RCM software also collects co-pays and handles the insurance eligibility process for patients.
Although RCM software helps with time management, it can also adversely affect how physicians handle electronic medical records and other hospital responsibilities.
Most physicians are trained in RCM software before it's implemented, but that doesn't mean the rest of the staff is.
The article “Physicians Beware! 3 Revenue Cycle Impacting Changes in 2015,” describes the complications surrounding RCM and the transition from ICD-9 to ICD-10 coding.
Revenue cycle management software requires specific coding in order to be effective. However, most staffs aren't trained in this type of coding, which causes headaches for hospitals and head physicians in particular.
RELATED TOPIC: Why the cloud is the safest place to store medical records
In other words, if a nurse or other staffer incorrectly codes a diagnosis, it creates a financial ripple effect for physicians as well as hospital billing cycles. RCM requires proper training, which is something hospitals and the physicians that run them aren't prepared to implement.
Revenue cycle management has untold benefits for city hospitals and larger practices, but what about smaller local practices?
Sometimes physicians at smaller practices feel pressured to use RCM software even when their in-house billing process is perfectly functional. This can lead to unneeded stresses, especially for smaller clinics that have no plans for expansion.
Likewise, if a physician only practices in one specialty, RCM software could be completely unnecessary.
Many specialty physicians use unusual codes and billing processes that in-house billing teams are already familiar with. Introducing RCM software could complicate tried and true billing techniques in smaller practices.
Although revenue cycle management software helps automate billing for hospitals, this could result in decreased communications between physicians and other staff members.
Inputting diagnosis codes and medical records can speed up the billing process, but the lack of communication that results could create issues down the line. This is especially the case in larger hospitals where head physicians manage more staffers.
RCM is still beneficial
The issues above are only a small part of the revenue cycle management equation.
There are plenty of benefits that go along with RCM software including workflow and claims management as well as electronic health record compatibility.
At the end of the day, it's up to the hospital and the physicians within to determine if RCM is the right choice.
Although beneficial, it's plain to see that RCM software can also hamper the way physicians run their practices.
About the author: Adam Groff is a freelance writer and creator of content. He writes on a variety of topics including the medical industry and health care technology.
Birdie aims to reinvent elderly care with tech
British startup Birdie has announced it has raised £8.2 million to invest in innovation and scale up the business.
The company's announcement is timely as it follows the criticism of the UK government over their lack of a plan for social care, despite acknowledging the sector is in crisis - around a quarter of the UK's home care providers are on the brink of bankruptcy due to a lack of funds and staffing.
Birdie was born with a mission to "radically improve the lives of millions of older adults", by using app-based solutions, IoT and machine learning to put preventative care at the forefront. The company was founded by Max Parmentier, after experiencing his own frustrations with the care system - his grandfather struggled with the impact of life in a care home, but lacked any other option.
In 2017 Parmentier partnered with venture builder Kamet Ventures to set up Birdie, in a bid to fix this problem. Since then, Birdie has partnered with almost 500 providers across the UK, and supports more than 20,000 older people every week. In the past 12 months alone the number of people Birdie supports has got six times greater.
Birdie’s solution is an app to help care providers deliver more coordinated, personalised and preventative care, by giving them access to digital assessments, medication scheduling and planning tools. By using digital tools to take care of admin, staff have more time to spend with their care recipients.
The new investment will be used to fund Birdie’s next phase of growth in the UK, as the company scales to meet the rapidly growing demand of the aging population. The company will also invest in product innovation, creating new features to address customer requests.
In addition, Birdie is piloting new care models, including partnering with the NHS to identify COVID-19 symptoms, building predictive pharmacy models with AI, and helping health authorities to detect early warning signs of patients’ health risks.
Internally, Birdie is committed to having a progressive company ethos. All salaries are transparent, and staff work asynchronously to maximise flexibility and equity. Staff members also volunteer in their local community during office hours, and the company offsets all its emissions.
These efforts have led to numerous awards, including having the best SME culture in the UK, an Honorable Mention in the Health category of Fast Company’s 2021 World Changing Ideas Awards, and innovation in care at the LangBuisson awards.
“We believe the future of care for older people should be helping them to live at home for as long as possible through the delivery of personalised and preventative care" Parmentier said.
"Birdie is already the partner of choice for caregivers up and down the UK, and this new funding will help us rapidly increase the number we partner with and what we can offer them - meaning more people benefiting from more affordable, quality care. We’re proud of our mission and the values we embody to pursue it.”