The healthcare industry, much like other sectors, has undergone a significant overhaul in its approach to delivering patient care. With telehealth services leveraging advanced technology platforms to offer remote clinical care to patients, this paradigm shift has been expedited primarily due to the widespread impact of the COVID-19 pandemic. However, this implementation of telehealth services has raised concerns amongst stakeholders about the efficient management of revenue cycles, thereby posing a considerable challenge to healthcare providers.
This article explores revenue cycle management (RCM) in the telehealth era. We will discuss what RCM involves, its importance in healthcare, and how telehealth has impacted RCM. Additionally, we will highlight the benefits of Remote Patient Monitoring (RPM) services in RCM, recommended practices for implementing RCM in telehealth, and the obstacles encountered when deploying RCM in telehealth.
Revenue Cycle Management (RCM) is the practice of overseeing financial transactions in the healthcare industry, including claims processing, payment, and revenue generation. This multifaceted process comprises several steps, such as patient registration, insurance verification, claims submission, and payment processing, making it a complex process to manage.
Efficient revenue cycle management is vital to maintain the financial stability and prosperity of healthcare providers. It guarantees that healthcare providers receive prompt and accurate payments for their services. Furthermore, RCM aids healthcare providers in reducing administrative costs, enhancing patient satisfaction, and optimizing their revenue streams.
Telehealth services offer medical organizations the potential for increased revenue, as patients who might otherwise cancel or fail to schedule an appointment are more likely to opt for this convenient option. Furthermore, medical providers can see more patients in less time without the need to physically move between rooms or buildings. Instead, they can meet with patients virtually, from the comfort of their single office, or even from home after hours, making it easier to offer services to rural areas that would otherwise be challenging to reach.
To optimize revenue and insurance coverage for telehealth services, medical office staff should be well-versed in the specific coverage provided by different insurance providers. Just as staff typically check patients’ insurance coverage when scheduling appointments, they should also ensure that telehealth services are covered by the patient’s insurance plan.
The revolutionary, cutting-edge technology known as Remote Patient Monitoring (RPM) services has become an absolutely essential tool for healthcare providers in their ongoing quest for efficient and effective revenue cycle management. With RPM services at their fingertips, healthcare providers are empowered to remotely monitor and track patients’ health in real time, collecting invaluable data on their medical conditions as they do so.
The inherent advantages of this remarkable technology are truly manifold, as it enables healthcare providers to bill for all manner of remote patient interactions, including even text messaging, while simultaneously driving up billable hours to unprecedented levels.
The quandary of whether or not to incorporate telehealth solutions into their operations is causing a great deal of anxiety for healthcare providers. The root of this anxiety is the persistent fear that such measures could potentially consume the longstanding, in-person, fee-for-service (FFS) business model that has served as the foundation of the industry for so many years. Nonetheless, it is becoming increasingly evident that health systems cannot feasibly maintain themselves with the antiquated FFS model, and must, therefore, actively pursue novel approaches to guarantee their survival in the constantly shifting healthcare landscape.
The incorporation of telehealth as a dependable delivery method presents health systems with an unparalleled opportunity to not only weather the ongoing pandemic era but also to connect and engage with patients effectively, regardless of their geographical location. As a matter of fact, telehealth has emerged as a veritable game-changer, particularly when it comes to addressing access challenges that could otherwise impede patients from seeking in-person consultations.
Leveraging telehealth affords health systems the opportunity to rake in profits by augmenting patient access and bolstering capacity. The higher revenue generated by telehealth stems from its unrivaled convenience, which is not restricted by geographical location. Moreover, telehealth removes several obstacles that often impede patients’ access to care during regular office visits, such as commuting, taking time off work, and securing childcare. Most telehealth programs are accessible via smartphones or tablets, eliminating location-based impediments. Patients can thus receive care from any location as long as they have internet connectivity. The removal of such access barriers makes it more likely for patients to seek out a provider’s services when the need arises.
In addition to augmenting revenue, telehealth is also a cost-effective solution for health systems compared to in-person care delivery. Consequently, the increase in telehealth visits translates to a higher bottom-line margin per patient visit.
There are several reasons why telehealth is a cost-effective option for health systems. First and foremost, telehealth leverages technology to automate routine check-in forms and information, thus decreasing the need for administrative staff. Though reducing staffing requirements may not generate new income, it remains a viable strategy for health systems to eliminate unnecessary costs.
The imposition of telehealth as a compulsory measure due to the pandemic has unearthed a startling revelation: despite the change in delivery mode, there was no discernible impact on health outcomes. Health systems, providers, and patients alike attested to the parity in quality between virtual and in-person visits. In fact, the increased frequency of patient-provider interactions proved advantageous, allowing for a better understanding of individual patient circumstances and a more tailored care approach.
Telehealth solutions have facilitated convenient access to care, resulting in more patients receiving timely medical attention. This has, in turn, enabled care teams to administer appropriate care promptly, leading to reduced readmissions. Additionally, the delivery of top-notch care through telehealth can improve care management participation, empowering providers to intervene early and enhance chronic disease management.
Remote patient monitoring (RPM) is a telehealth service that allows healthcare providers to remotely monitor patients’ health data and vital signs in real time.
RPM services can improve revenue cycle management by reducing denied claims, reducing no-shows and cancellations, and reducing the cost of care.
Some best practices include selecting the right RPM platform, ensuring that patients are trained and comfortable with the technology, and establishing clear policies and procedures for RPM data collection and analysis.
Healthcare providers can maximize revenue by accurately documenting and coding all telehealth services, ensuring that patients are billed accurately and in a timely manner, and optimizing their revenue cycle management processes to minimize inefficiencies.
Telehealth regulations can impact revenue cycle management by affecting billing codes, reimbursement rates, and other factors. It is important for healthcare providers to stay up-to-date on the latest regulations to ensure compliance and optimize their revenue cycle management processes.
In conclusion, revenue cycle management is a critical process for healthcare providers, especially in the era of telehealth. By leveraging remote patient monitoring services, providers can improve patient outcomes, reduce healthcare costs, and streamline their revenue cycle management processes. It is important for providers to stay up-to-date on the latest regulations and best practices in order to maximize revenue and provide high-quality care to their patients.
"This story illustrates the power of remote patient monitoring. Our doctors can’t monitor us all the time, and the limited snapshot they get from office visits often doesn’t paint the whole picture."
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