Medical Billing Services vs. Revenue Cycle Management: What's the Difference? 

Your practice can not survive without revenue. While most of your payments come from medical billing, your financial success depends on many other factors. If your practice needs help boosting its revenue, a medical billing service or revenue cycle management company may be the solution. Here is what your practice needs to know about medical billing services vs. revenue cycle management. 

What Is Medical Billing?

Medical billing is the process of submitting claims for payment. When a patient visits your office, your providers and staff transform the diagnoses and services describing that visit into common codes. Diagnoses are generally coded using the International Classification of Diseases volume 10 (ICD10). Procedures are coded using the Current Procedural Terminology codes (CPT) and the Healthcare Common Procedure Coding System (HCPCS). Your medical billing specialists or medical billing service will aggregate codes into a claim, check it for accuracy and completeness, and submit it to insurers for payment. 

What Are Medical Billing Services?

Medical billing services help your practice submit claims for payment. A medical billing service will scrub, submit, and follow up on claims to ensure prompt and accurate reimbursement. Medical billing support can range from the placement of temporary medical billing specialists in your office to full outsourcing of your medical billing process.   

Medical billing services have extensive experience with coding and claims. They can reduce your claims denial rate and increase total payments to offset the costs of the outsourcing contract.    

But medical billing should not be your practice's only focus when it comes to revenue. Revenue cycle management offers a broader picture of your practice's financial performance. 

What Is Revenue Cycle Management? 

Revenue cycle management goes beyond medical billing. Your revenue cycle includes all the policies, procedures, and tasks affecting your practice's revenue streams. Working with a revenue cycle management company can make your practice more efficient and prepare you for growth. Here are a few key aspects of revenue cycle management that extend beyond medical billing. 

Patient Registration

Your revenue cycle begins when a patient makes an appointment with your practice. You must gather and verify insurance information, including any prior authorization requirements, to ensure effective medical billing after the visit. But these insurance processes are not typically handled by a medical billing service. If your practice struggles to manage patient insurance information, a revenue cycle management company may be able to streamline your workflows. 

Patient Payments

Patient payments are an essential source of revenue that traditional medical billing services often do not cover. Collecting copayments and coinsurance from patients can be complex and significantly affect your practice's income. A revenue cycle management company can configure your Practice Management's Patient Portal function to estimate and collect payments. They can also work with your front desk staff to redesign your check-in workflows so patients can make payments before their visit. 

Coding by Providers

Medical coding does not begin with your medical billing specialists. Your providers should begin the coding process during patient appointments to ensure completeness and accuracy. Revenue cycle management companies offer workflow redesign support and training to help providers code more effectively. 

Reporting

Reporting is a critical piece of revenue cycle management that goes beyond medical billing. A medical billing service will not prepare your practice's financial statements and other reports. A revenue cycle management company can develop custom reports and dashboards to help you keep your practice on track. For example, TempDev's Revenue Cycle NextGen EPM Dashboard tracks your claims denials, A/R aging, and payments to ensure your revenue cycle runs smoothly.   

Revenue cycle management companies can also integrate your Practice Management System with your general ledger system to ease financial reporting. And they can implement business intelligence tools to create custom reports and dashboards that fit your practice's goals. 

When Should Your Practice Use Medical Billing Services vs. Revenue Cycle Management? 

If your practice does not have sufficient claims volume to support a team of medical billing specialists, a medical billing service is a good option. Medical billing services can also provide temporary staff to cover planned absences or fill in during vacancies. Medical billing services generally handle claims submission and processing but do not offer consulting or other services to improve your appointment, coding, or reporting processes.   

Revenue cycle management companies offer a broader suite of services than medical billing services. Busy, growing practices may benefit from working with a revenue cycle management company. Your coding and financial workflows and reporting processes become more critical the more significant your practice gets. Revenue cycle management companies offer consulting services to boost your revenue cycle. 

How TempDev Can Help with Medical Billing and Revenue Cycle Management

TempDev offers many services to meet your medical billing or revenue cycle needs. TempDev's consulting services and Dashboards help you get and keep your revenue cycle on track. If you need additional support, we offer temporary staffing, co-sourcing, and outsourcing via TempBill.   

Call us at 888.TEMP.DEV or contact us here for answers to your medical billing services vs. revenue cycle management questions.