Up to the minute information for your financial success. 

January 4, 2013

To ensure you receive future Minutes, click this link .

To ensure you don't, click here to opt out .

PBN Live!  Visit PBN at the ASA Practice Management Convention in Las Vegas, January 25 - 27, Booth 301.  PBN is an ASA Sponsor for 2013.

The "Four C's" of Revenue Cycle Management (RCM):  An Introduction

M edical Billing, nowadays known by the term “Revenue Cycle Management” or RCM, is as the name implies, a continuously repeating cycle.  It’s a process with a definite beginning (a service is provided) and end (payment is received), but with many steps in between.  Most conceptual models of healthcare revenue cycles have between 15 and 30 discrete steps between service and payment.  These models might be helpful in describing the intricacies of the process, but are also too linear to show how each step is interrelated and too complicated and detailed to allow you to see which areas are most important to focus on as a business.

The 4 C's . . .

In this and the following four articles, we’ll walk through the 4 C’s, outlining how each step is critical to medical billing and the financial success of your  practice or other healthcare provider organization.  As the image depicted here shows, rather than four or more separate steps in a process, each of the emphases in the four C’s model overlaps the others to illustrate how each area is an important part of the other areas:  you can’t negotiate effective contracts without considering Compliance issues and requirements; you can’t develop effective Collections practices without tying your Collections efforts into accurate Coding, and so on.  This series of articles also reviews how each of these RCM focus areas plays a critical role in each of the other areas.

A Preview . . . 

Compliance.   The risks:  corporate and personal legal liabilities, civil and criminal.  The rewards: compliance can be part of developing best practices that improve your efficiency and profitability.

Contracts.   What is negotiable in payer and provider contracts?  What’s “standard?”  What contract clauses should physicians look out for?  How do you know a contract is fair?

Coding.   Understanding the connections between correct, accurate, and, clean claims, efficient coding practices, and optimized, timely payment.  Why will coding process accuracy be critical under ICD-10?

Collections.   PBN estimates that “working” your aging A/R can net your practice 15% (or more) added revenue.  How does it work (it’s not traditional “hard” collections)?  Why is understanding the relationship between costs of collections and the difference between net and gross revenue critical for your future success?

Ultimately, we hope understanding how these four conceptual focus areas work together within an overall business framework based on quality will help your practice prepare for the many upcoming changes and grow into the future.
 
 

  . . . PBN is here to help.  Contact PBN Business Development, 800.288.4901 or .

All content © 2013 Physicians Business Network | 8900 Indian Creek Parkway, Suite 500 
Overland Park, KS 66210 | 800.288.4901 | pbnmed.com

Opt-in to subscribe. | Opt-out to unsubscribe.