…And How the Right Personnel Fill the Gaps No Software Can
Managing your facilities’ accounts receivables and billing is the backbone of your revenue cycle. Mastering your revenue cycle, however, requires more than just the right billing software.
As healthcare technology evolves, a plethora of billing solutions have emerged for a variety of specific use cases, including long-term care. Even these advanced solutions, however, cannot independently address the needs of the industry’s complex billing requirements.
The secret ingredient that the most successful operators have, in addition to the right LTC billing software, is the right personnel.
Only trained specialists with the knowledge of post-acute and long-term care (LTC) have the experience and time needed to know the industry’s intricacies and how these impact your revenue.
Why Software Alone Won’t Fill Gaps in Billing
LTC billing software is excellent for streamlining the collection of data needed to bill payers and accurately submit claims. Billing codes, patient information, and other essential data can be seamlessly pulled from your existing electronic health records (EHR) systems, making billing officers’ jobs more efficient and claims more accurate.
Where software falls short, however, is helping billing officers know if the format or information required to bill a specific payer—especially managed care payers—is incorrect or missing.
Claim denials are most commonly the result of billing errors and create a time-consuming recovery process that can be avoided altogether by submitting the right information in the right format at the outset.
Most modern billing software aids users by ensuring vital information is present, but as more complex payer networks emerge, requirements change and payers demand more information.
Here’s where a post-acute or LTC billing expert can support your team to make sure claims are being submitted properly and tracked through final payment. Personnel with this particular expertise in your business office support your revenue cycle by working diligently now so reimbursements reliably arrive later.
The Human Element Is Essential in Long-Term Care
Even as technology in the industry advances, one factor remains critical to providing quality care and has proven itself irreplaceable. The human element. Your back office is not exempt from this truth.
At present, there is yet to exist a software solution so intelligent and so adaptable that it can ensure proper LTC billing practices for every payer type.
High-performing business offices are adopting an approach that complements their technological solutions with specialists to provide acute oversight and perform due diligence.
This solution means operators need to bring the best systems they can afford into their facilities and pair that with the most experienced billing and AR experts available. This winning combination has been shown to produce an optimal revenue cycle.
For many operators, integrating this level of sophistication into their internal business office is prohibitively expensive. Outsourcing, however, has allowed LTC operators overseeing dozens of facilities to standardize their RCM processes and achieve excellent results without breaking the bank.
At LTC Ally, we have developed advanced systems that track claims and denials across hundreds of facilities that are supported by teams of dedicated specialists with deep industry expertise. Our RCM department helps operators of all sizes optimize their billing, AR, and collections, routinely capturing millions of dollars sitting in aging claims.
See how we helped one such operator with their billing and collections and ultimately improve revenue:
Read Case Study
Related Articles:
- How Your Long-Term Care Organization Can Improve Its RCM
- What Is End-to-End Revenue Cycle Management?
- Meet LTC Ally’s EVP of RCM