Improving the RCM process is simple even though it can often look complicated from the long view. Here are a few steps for aligning the process:
1. Provide an up-front patient insurance authorization checklist to staff doing admissions to reduce common error of no-authorization.
2. Receive denial requests in one location (single point-of-entry) instead of multiple places to allow for consistent data collection and to keep better track of time-to-payment received based on types of requests by payer.
3. Build a template or database for the most common types of insurance requests received by payer and the attachments that need to be submitted on the front end with initial claim.
4. Provide items needed from patient authorization/case management checklists, if they don’t already have access.
5. Provide a systematic way for billers to submit attachments that provide necessary information for insurer.
6. Submit necessary documents to the payer; build a database or table of submittal communication items needed and automate this into electronic attachment submittals and responses.
7. Conduct admission process review using best practice research.
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