Revenue Cycle Management

Understanding Revenue Cycle Drivers in Your Health System

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ling and claim filing play critical roles in keeping your medical practice financially healthy, but beyond tracking accounts receivable and individual patients’ accounts, do you know where to look to see what’s keeping your revenue moving? Many medium-size practices don’t have the time or expertise to accurately follow their cash flows and revenue streams, whereas large networks can have teams dedicated to this task, known as revenue cycle management (RCM).

If you feel in the dark about where your money is coming from and what you can expect to see come into your practice both next month and next year, you’re not alone, and PayrHealth can help.

Your Key Revenue Drivers

There are two branches of revenue flow, with one being far larger than the other, but one that requires (usually) more effort on your part to ensure it gets to your books. Although insurance payments are critical to your revenue, making collections more efficient can also help lower overhead costs and reduce tedious tasks for your staff.


Your insurance providers cover the lion’s share of the codes you submit claims for, but that doesn’t mean they’re always easy to deal with, nor are you always paid on-time for exactly what you deserve to get. Claim forms can be complex and the rules about timing and coding change seemingly at random. It’s a lot to keep up with, even for those whose entire job it is to code and file claims.

This leads to a problem for providers: claims can come back rejected or under-paid, at which point, many don’t have a strategy or the bandwidth to re-submit them correctly or communicate directly with the payor to settle the dispute. PayrHealth’s revenue cycle management team, however, does. We have the infrastructure, labor capacity, and expertise to file claims on your behalf using automated systems that submit clean claims nearly every time. We also have standing relationships with many of the nation’s top payors, giving us access to escalations that save everyone time and energy while ensuring you get paid what you’re owed, on time. If you have a problem with claims filing and denials, we can help.


Another hassle for your front office staff is following up with patients once their bill goes past due. Whether their coverage wasn’t accurate or you didn’t ask for a co-pay at the time of the visit, this can mean lost revenue that will add up over time. This requires robust front office workflows including verifying insurance coverage before providing services every time (unless they want to pay out of pocket), and collecting current information every time so your office can reach out to them when necessary.

Of course, with a partner like PayrHealth, our team can handle all of this for you, so you can focus on providing quality care and your office staff has to field fewer calls.

Shoring Up Your Revenue Cycle With A Trusted Partner

As a medical provider, your responsibility is ultimately to your patients, but you can’t serve people unless you can operate with a healthy revenue stream from payors and patients alike. By partnering with PayrHealth’s RCM team, you gain a team of industry experts who report monthly to you about the state of your accounts and revenue streams, keeping you involved as much as you want to be while we handle the claims submission and bill collection process with our tools and proven workflows. To learn more about how our services can help boost and salvage your revenue cycle, call us or contact us online today.

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