Gabriela Alcaraz Regent RCM

Meet the Team | Gabriela Alcaraz

Over the next few months, we will be introducing the many members of our team who make Regent RCM so successful. In our last post we learned more about HST Database Administrator & Revenue Cycle Specialist Irma Arellano. Today, let’s meet:

Name: Gabriela Alcaraz

Hometown: Chicago

What do you do at Regent RCM? Revenue Cycle Specialist

How long have you been working at Regent RCM? 10 years

What is your favorite part about working here? Being able to perform a variety of revenue cycle functions and not just being a medical biller.

What has been your greatest professional achievement? Continuing to meet my expected goals and maintaining the same level of proficiency while assisting others to achieve their own personal goals.

What is one fun fact about yourself your co-workers don’t know? I love horses! I enjoy riding horses.

ASC Nurse evaluating revenue cycle

The Benefits of Outsourcing RCM: Using Best-in-class Technology for Process Automation

Over the course of March, we are diving deep into four key benefits of outsourcing revenue cycle management (RCM) for ASCs. Last week, we examined the importance of leveraging the expertise offered by RCM providers in billings and collections, especially in light of ICD-10. This week, we take a closer look at the ways in which RCM providers can bring workflow and process optimization that utilizes best-in class technologies to your ASC.

There are three types of technologies RCM providers use to optimize the billing and collection process:

  • Management Information Systems (MIS) are the lifeblood of your ASC Business Office. With the right MIS, you can do everything from inventory management to insurance verification and patient billing to surgical scheduling. Some advanced MIS use workflow which enables end users to work from real-time tasks assigned by management, ensuring the greatest level of efficiency. With these systems in place, ASCs can maximize their profitability, lower AR days, and achieve faster reimbursement.
  • Clearinghouse software, aside from sending claims, can also provide claims management, electronic remittance advice (EOBs), eligibility verification, and patient estimation. Users can verify a Patient’s insurance benefits, determine their co-pays, deductibles, co-insurances, and out of pocket maximums. This will accurately estimate the patient’s responsibility, allowing us to financially counsel the patient prior to the date of service, resulting with increased upfront payments and fewer outstanding balances. A clearinghouse that allows users to create customized edits, so unclean claims are kicked back before being sent to the payer, will certainly help in reducing AR days. Clean claims are vital for a healthy revenue cycle; the more efficiently you can process claims, the faster you can get your payment.
  • Reporting and Analytics are the key to constant improvement. The deeper insight you have into the way your ASC operates, the more opportunities you have to make changes and optimize outcomes. An analytical tool that will pull data from your information management system and allow you to slice and dice data in any number of ways yielding useful information is key. A real-time dashboard will give you real-time access to metrics of your choice, and warn you of RCM issues.

But what’s to prevent an ASC from simply going out and buying these tools directly? There are a number of benefits of using an RCM provider to update your systems and integrate new technologies.

First, choosing an RCM technology system is a complicated process. There are many options available in the market, all at different price points, offering very similar benefits. How can anyone be expected to know which one is right for their particular ASC? RCM providers have a deep understanding of not only the tools available, but how they work together, and for which ASCs they work best. They’ve tested, vetted and priced them out so you don’t have to.

Price is another factor here. If your ASC were to go out and purchase this technology, it would cost far more than it would to get it from an RCM provider. They have determined the best tools available, and use them for many clients, receiving heavily discounted rates that they are able to pass along to their clients.

Most importantly, though, is that RCM providers have an intimate knowledge of the systems and their complexities. As we mentioned in the last article, one of the biggest benefits of outsourcing RCM is having pre-trained staff who are already familiar with technology that typically involves a steep learning curve.

But it goes beyond that; they know which tools work well together and which ones work in silos. They have enterprise dictionaries already built for the MIS, so that only Facility specific information needs to be inputted, i.e. doctors, patients, inventory, and chargemasters.  Their familiarity with the systems extends to implementation as well. Implementing new technology at an ASC typically takes more than three months. With an RCM partner, it will take as little as 30 to 60 days.

As ASCs and other health systems scramble to keep up with the changing healthcare landscape, it is imperative to have the latest technology, and a keen understanding of how to use it. Without these essential tools, your ASC stands a good chance of being left behind.