Jun 14, 2024

Revenue Cycle Management Starts at Intake


Effective behavioral health revenue cycle management (RCM) should include a thorough intake process. Often seen as a simple administrative task, intake is actually a key component of the RCM. Improving this step can greatly benefit your revenue cycle. Let’s explore how.

Collecting the Right Information

Every behavioral health program or facility has specific forms needed during the intake process. Some information, however, is essential across all programs. Here are some key details to gather:

  • Patient Demographics: Ensure these are verified and validated. Accurate demographic information forms the foundation for the billing process. Correct addresses, phone numbers, date of birth, etc. prevent billing errors later.
  • Insurance Information: Include details on co-pay, deductible, policy limits, out-of-network rates, and policies. Understanding the patient’s insurance coverage helps in predicting and managing financial flows.
  • Co-Insurance Information: Gather any relevant details about co-insurance. This information helps clarify the patient’s financial responsibility and reduces confusion later.
  • Out-of-Pocket Payments: Document information on these payments. Clear records of what the patient has paid out of pocket help avoid billing disputes.
  • Plan-Specific Guidelines: Note any specific guidelines for the client’s plan. Each insurance plan can have unique rules that affect billing and payments.

Ensuring Information Accuracy

Accuracy is vital, yet often overlooked. Collecting complete information from the client and recording it accurately can lead to numerous benefits:

  • Smooth Benefits Verification: Accurate information streamlines the verification process. When you verify benefits accurately, it prevents delays and misunderstandings.
  • Reduced Claim Rejections: Eliminating common errors reduces the frequency of rejections. Accurate information at the start reduces the need for claim resubmissions.
  • Timely Billing: Ensuring accurate details helps send bills on time. Timely billing is crucial for maintaining a healthy cash flow.
  • Efficient Payment Collection: Correct information aids in collecting payments and crediting them to the client’s account. Accurate records simplify payment reconciliation and reduce administrative burdens.

Nextus has developed systems to assist with this. Our built-in checkpoints help spot errors or discrepancies in the information. Our ‘measure twice, cut once’ approach maintains a 99% first-pass acceptance rate for claims. This makes the revenue cycle management more efficient and productive for your program.

Additional Forms

There are other forms that can be useful during intake, especially if a carrier has questions or needs permissions. These forms include:

  • Consent to Treatment: Ensures the patient agrees to the treatment plan.
  • HIPAA Notification Acknowledgment: Confirms the patient has been informed about their privacy rights.
  • Release of Information Form: Authorizes the facility to share patient information as needed.
  • Financial Assignment of Benefits: Allows insurance payments to be made directly to the healthcare provider.
  • Other Necessary Forms for Your Facility: Depending on your specific needs, additional forms might be required.

How It Helps

Attention to detail at the start of the process pays off later. Accurate initial claims lead to quick reimbursements, avoiding delays and resubmissions. This means payments are received on time, and resubmission expenses are minimized.

Being thorough upfront also aids in collecting co-pays and out-of-pocket expenses. Clients are more likely to pay invoices quickly when they expect them and understand the charges. This transparency helps them feel prepared, reducing surprise or distrust about their bills.

A comprehensive intake process also improves patient satisfaction. When patients understand their financial responsibilities and see that their information is handled correctly, they trust the facility more. This trust can lead to better patient retention and more referrals, which are valuable for the growth of any healthcare practice.

How We Can Help

Nextus is here to help you manage your revenue cycle efficiently. We aim to maximize your revenue while reducing your administrative burden. By allowing us to handle the RCM, you have more time to focus on what you love: helping your clients.

Our systems are designed to catch errors before they become problems. This proactive approach ensures that your claims are processed smoothly and that you get paid faster. We also provide detailed reports, so you always know where your revenue cycle stands.

Schedule a consultation with us to discuss how Nextus Billing Solutions can enhance your behavioral health revenue cycle management. We would love to learn about your needs and help your program thrive. By partnering with us, you can ensure that your billing process is as efficient and effective as possible, leading to better financial health for your practice and more time to dedicate to patient care.