Which Revenue Cycle Management Software Is Right for You?

January 4, 2023

Revenue cycle management software: entrepreneur briefing her team

Financial concerns along with patient access and staffing shortages were the three major challenges behavioral health leaders faced in 2021, according to a report by HealthLeaders Media. And it’s not just behavioral health professionals that are worried. A recent survey shows that after staffing concerns, the main thing health care industry CEOs worry about is cash flow, including Medicaid reimbursements and commercial insurance payments. 

Choosing the right revenue cycle management software can help streamline workflow processes, boost operational efficiency, improve patient satisfaction, and increase profitability. We’ll outline here the things you need to consider, including the type of revenue cycle management (RCM) you need, whether to use a specialty provider, and if you should choose a comprehensive solution or multiple stand-alone RCM services.

In-House vs. Cloud-Based Revenue Cycle Management Software

Infrastructure and equipment pricing is just as important a consideration when choosing an RCM software as when deciding upon in-house versus cloud-based electronic health record (EHR) vendors. 

In-house software is hosted on your computer or on a server that you physically control. This solution may be more technical and resource-intensive. Not only are you responsible for the care and upkeep of expensive equipment and software systems, but you must also maintain the privacy and security of sensitive personal health and financial data. Moreover, there could be financial implications if you outgrow your system or want to add new technology.

Cloud-based RCM software is hosted by a server that is off-site and maintained by the vendor. You only need an internet connection to access programs. When choosing a cloud-based software provider, select one that enables your growth. Look for vendors that not only meet your needs today but anticipate the future.

ContinuumCloud’s EHR includes RCM functionality in a 100% cloud-based system to provide critical access when you need it from wherever you are. There is no software or hardware to install and maintain. All your data is encrypted and saved to a professionally maintained server.

General RCM Software vs. Specialty RCM Software 

Revenue cycle management software: team volunteering to pack donations

Behavioral health RCM is complicated. From justifying a treatment plan’s medical necessity to unique billing requirements and coding nuances, behavioral health RCM demands precise understanding that general services may not offer. 

ContinuumCloud provides expert health IT services and software solutions like EHR and RCM exclusively for behavioral health organizations in the following areas:

Standalone vs. Comprehensive Revenue Cycle Management Software

Standalone products that only focus on a specific step in the revenue cycle may lead to a siloed work environment. You may need to contract with several software vendors to accomplish the RCM process. This scenario could lead to additional costs for training your staff and extra licensing fees. Plus, with different vendors, you may lack functionality between products. 

Because comprehensive revenue cycle management software is designed for interoperability, everything works together. A well-designed comprehensive solution can increase the effectiveness and profitability of your team by streamlining workflow processes, boosting productivity, and delivering more value to your organization. 

There are several key features to look for in a comprehensive practice management solution.

Integration of EHR With RCM

A comprehensive RCM solution doesn’t just connect the front office to the back office, it also loops in the clinical practice in a meaningful way. 

For example, when the EHR and RCM are integrated, precise data needed by billing and coding is readily available and workflow processes are streamlined and efficient. This is especially important if you have a remote workforce, or if you are outsourcing any part of your medical billing services. 

ContinuumCloud’s EHR software includes an end-to-end RCM solution. It includes practice management tools like pre-scheduling, self-check-in, real-time eligibility checks, HIPAA-compliant communication features, mobile functionality, patient account portal, patient payment processing, advanced reporting, and compliance. 

Automation of Processes

Automated scheduling, billing, claims processing, and claims denial not only ensure the financial health of your practice, but they also improve the patient experience.

Some practices rely on manual claims submission processes. Because of small inconsistencies, errors, or typos, a portion of those claims will be denied. This may result in missed opportunities for revenue, frustrated patients, and overworked employees. 

ContinuumCloud’s behavioral health RCM automation of the medical billing cycle starts with eligibility verification. Claims management automation ensures clean claims before submitting and keeps up with deadlines so that revenue isn’t at risk.

Assurance of Compliance

Without revenue cycle management software, some practices may overlook requirements in complex Health Level 7 and HIPAA regulations or fail to comply with state, county, and federal reporting requirements.

ContinuumCloud’s revenue cycle management solution helps your healthcare organization stay in compliance with easy documentation and report submissions. Our software makes sure you comply with the latest regulations by automatically checking for human errors like missing data, incorrect billing codes, and other problems. 

Measurement and Reporting of Data, Benchmarking, and KPI

Being able to transform data into readable, actionable reports can help providers understand which measures payers use to assess quality of care, such as patient experience, cost, efficiency, and outcomes. 

As we approach value-based payments in behavioral health, providers will need to provide proof of improved quality of care, patient experiences, and reduced costs.

Beyond institutional or government requirements, benchmarking best practices with external HCOs and measuring internal key performance indicators (KPI) can help you optimize and transform your health care processes to improve financial sustainability and increase satisfaction for patients and employees. 

ContinuumCloud provides access to industry data so that it’s easy to compare and measure processes and outcomes like‌: 

  • Staffing ratios
  • Staff retention
  • Staff training
  • Patient discharges
  • Waiting time for patients
  • Patient experience and patient satisfaction scores
  • Re-admission of patients
  • Sentinel events
  • Safety incidents
  • Medication errors
  • Insurance processing time
  • Operational costs vs. charges
  • Claims denial rates

Our RCM reporting dashboard lets users access over 1,200 types of report templates and interact with data like active clients, schedules, behaviors, cycle summaries, treatment plans, claims, and billing information. You can also create stakeholder reports on every aspect of your practice, including revenue, billing and reimbursement, and staff workflow efficiencies.

ContinuumCloud Revenue Cycle Management Software

Team putting their hands together

Stand-alone software that manages specific parts of the RCM process like accounts receivable, billing systems, and claims processing may seem like a cost-effective approach to practice management. That is until you add up all the costs, such as equipment, training, and licenses and factor in the risks, such as privacy and data breaches, compliance issues, and incompatibilities.

Instead, consider partnering with a vendor that offers a comprehensive EHR-integrated solution specifically for the behavioral health and human services industry that combines billing, collections, claims automation, and claims denial management with advanced functionalities like monitoring KPIs, reporting, and compliance.

By investing in technology like ContinuumCloud’s EHR, you’ll not only get an innovative RCM solution today but a team of behavioral health care IT experts dedicated to helping your organization build a sustainable behavioral health practice for the future.

Are you ready to find out what comprehensive EHR with integrated revenue cycle management software can do for your team? Book an appointment online and connect with a behavioral health IT expert today.

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