Keys to Effective Revenue Cycle Management for Home Care
Overview
The demand for home health care services will grow as more elderly populations prefer to age at home. Even with the growing demand, home care agencies will face significant headwinds in the future. Falling reimbursements, increasing labor costs, and regulatory requirements will pose many operational challenges. Effective Revenue Cycle Management will improve operational efficiency, cash flow, and the bottom line for home care agencies.
The Revenue Cycle Management (RCM) process starts at intake and continues through authorization, scheduling, billing, and collections. Home Care Agencies must integrate the RCM process with operations to capture, bill, and collect revenue for all the services provided. Agencies should review the RCM process periodically and adjust the process to accommodate the changes in the patient and payer mix.
Home Care Agencies must leverage technology and software to automate repetitive and time-consuming revenue cycle tasks. Management by Exception throughout the RCM process will help home care agencies to do more with less.
This blog will discuss some critical features Home Care Software requires to manage revenue and collections to improve cash flow and the bottom line.
INTAKE
Effective Revenue Cycle Management starts with Intake and Referral Management. Collecting complete and accurate information, such as patient demographics, insurance,
etc., is essential to correct billing and timely reimbursement. The following are some intake functions that will help home care agencies.
Configurable Validations: The software should be able to provide proactive alerts for missing patient information at the time of intake. These alerts will help the intake staff collect as much information as possible. Configuring the validations will help the agencies select the alerts based on their unique needs.
Eligibility Verification: The ability to verify eligibility in real-time at the time of referral or intake will help the agencies ensure the patient has the right coverage for the services. The software should also have the option to verify eligibility in batch mode to verify eligibility for current patients periodically. Automatic alerts for any discrepancies will be beneficial.
PECOS and NPI Verification: The ability to verify NPI (National Provider Identifier) and PECOS (Medicare Provider Enrollment, Chain, and Ownership System) during intake will eliminate future denial of claims.
Intake Exception Reports: Scheduled Intake Exception reports will help intake staff continuously monitor missing and mismatched information.
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