Revenue Cycle Management 2021 Changes

Revenue cycle management may be one of the most important processes in any medical practice. Without a strong RCM procedure, practices are at risk of missing out on reimbursement and seeing dangerous reductions in revenue. So what is happening in 2021 that practices need to be aware of as it relates to RCM? Let’s take a look.

Work from home

As COVID-19 spread across the globe beginning in March 2020, so did some major changes in how we approach our lives. Work from home went from being a nice idea to a necessity, and suddenly those working in medical billing were doing so from their home. While this has been instrumental in infection control and has also brought about some greater job satisfaction for employees, it hasn’t been without its challenges. Namely, when dealing with RCM in a work from home setting, it’s necessary for practices to ensure that the digital work solutions they’re employing provide assurance of security and compliance controls, along with ways to ease productivity concerns. Essentially, practices need to make sure that work from home doesn’t disrupt the billing cycle.

Shift to patient as a payer

This is something we’ve been seeing for the past several years. As high deductible health insurance plans have increasingly become the norm, patients are now responsible for a greater share of their healthcare costs than ever before. This doesn’t seem likely to change any time soon. Unfortunately for medical practices, collecting payment from patients is more complex and often more difficult than submitting claims with payers. This change creates the need for practices to determine what might be standing in the way of timely payments for patients and removing as many of those obstacles as possible. Solutions like eStatements and ePayments can go a long way in addressing these concerns.

Surprise billing

New legislation is being issued beginning in 2022 that is meant to protect patients from unexpected medical bills. This mostly applies to bills from out-of-network providers, especially in emergency situations, but it will require due diligence from providers to make sure that they are accurately listed in all payers’ directories and, in some cases, that they are providing timely cost estimates in advance of service. This is, if nothing else, something to be aware of as a potential roadblock to receiving expected reimbursement and are something to prepare for in 2021.

Increased data security risks

The healthcare field has been hit especially hard by cybercriminals in recent years. Data breaches are anything but cheap, costing roughly $7.13 million annually for the healthcare industry, and causing the potential for disruptions to patient care as well. It’s imperative in this environment that practices take a proactive approach to cybersecurity and mitigating the risk of adverse events as much as possible to avoid the potential financial fallout from a cyber attack.

RCM automation

Up to this point, the RCM process in many practices has remained largely manual, but it’s becoming abundantly clear that automation is integral to streamlining this process. With increasingly complex payer rules, new modes of care delivery such as telehealth, and a variety of payers to deal with, automation can make the difference between a surviving practice and one that is thriving.

RCM is one of the most important processes within a medical practice, and it’s important to stay on top of the trends that can provide challenges and opportunities in this space. After the unprecedented year of 2020, we’re seeing that some changes are still on the horizon and some holdovers from the last year may be here to stay, such as work from home. To be sure that you’re ready for it all, make sure you’re partnered with a strong practice management software like MicroMD PM. Our PM solution automates billing processes and revenue cycle management so you can keep your focus on the business of healing.

For more information or to get set up, visit www.micromd.com or call 1-800-624-8832.