Operating a healthcare practice in New York State entails a one-of-a-kind set of challenges. For example, you must navigate complex insurance systems and maintain compliance with regulations that are always changing. In an ever-changing environment like healthcare, managing your practice’s financial health is just as important as providing exemplary patient care. Therefore, a strong Revenue Cycle Management service in New York plays an important role in that process.

In fact, New York healthcare providers in all boroughs—Manhattan, Brooklyn, Queens, the Bronx, or Staten Island—can unlock concealed revenue and improve cash flow with A/R Recovery and Claims Resolution Support services. Crucially, all of these are essential RCM components to assure you are compensated in full and in a timely manner for the care you provide.

What is RCM?

Revenue Cycle Management is the full financial bottom line of patient care. Specifically, it covers everything from scheduling and insurance verification to billing, collection, and receiving the final payment. In a city like New York, where costs for running a healthcare business are the highest, one dollar is just as important as a hundred dollars. Ultimately, an effective healthcare RCM New York process ensures that claims were submitted correctly, payments are received timely, and consequently, the number of denials is minimized.

RCM includes the following core steps:

• Patient registration and insurance verification
• Medical coding and charge capture
• Claims submission
• Denials management
• A/R follow-up
• Collecting and reporting

Clearly, every process must be streamlined in order to reduce revenue loss and comply with local, state, and federal laws.

Why Do New York Providers Need A/R Recovery?

Accounts Receivable (A/R) means claims or balances due from patients or insurers. Ageing A/R, however, threatens consistent cash flow for many New York practices. Indeed, claims can get lost in the chaos of high patient traffic and complex payer networks.

Reputable A/R recovery services, in essence, offer these key functions:

• They review outstanding balances.
• Next, they prioritize claims based on amount owed and age.
• They identify and then address issues causing non-payment.
• Furthermore, they contact payers and/or patients to collect outstanding balances.
• Finally, they correct and resubmit claims where necessary.

By outsourcing their A/R recovery to specialists familiar with New York payors and billing rules and regulations, practices can recover revenue faster and, moreover, minimize write-offs.

Resolutions for Claims Denials with Claims Resolution Support

Claim denials are almost commonplace in New York. This is because Medicaid, Medicare, and private insurers all have varying rules. Each denied claim is a lost opportunity, but only if it is not dealt with quickly and in the proper way.

Claim resolution support emphasizes the following actions:

• Reviewing the denial reasons
• Then, correcting documentation or coding errors
• Resubmitting the claims in adherence to the timely filing limits
• In addition, appealing unjust denials with proper documentation
• Crucially, putting procedures in place to prevent similar issues from happening again

An experienced claims resolution team improves collections and, as a result, increases the efficiency of your revenue cycle. Consequently, your staff can place their focus on patient care

Why RCM Services Are Essential for the New York Healthcare Marketplace

To succeed in the crowded and highly regulated New York healthcare marketplace, providers need to operate at their utmost efficiency. Considering rapidly escalating administrative costs and dwindling reimbursement rates, the vast majority of private practices, clinics, and speciality providers are looking to RCM professionals for help with their financial well being.

Advantages of hiring a New York RCM service provider include:

• Rapid Payment Processing: Specialist efforts and clean submissions mean reimbursement will take less time and happen faster.
• Lower Denial Rates: Professional monitoring and cleaning will help prevent denials from New York insurers.
• Higher Collection Rates: Custom A/R strategies can achieve higher recovery rates on old or past-due claims.
• Regulatory Compliance: They help you maintain compliance with New York healthcare laws and rules from payers.
• Elevated Focus on Care: Your team is free to focus on what you do best: providing exceptional patient experiences.

Choosing an RCM Partner in New York

Not all revenue cycle management services in New York are the same. If your practice is located in New York, you will want to choose an RCM partner that is well-acquainted with the dynamics of healthcare in New York. Furthermore, they should have experience with payor sources, including Fidelis, EmblemHealth, Healthfirst, and UnitedHealthcare of New York.

Important factors to consider are:

• Knowledge of New York Medicaid and commercial insurance policies
• Experience working with local hospitals and speciality practices
• HIPAA compliant software integration
• Real-time reports on performance dashboards
• Transparent billing and assigned account managers

Whether you are a solo provider located in the Bronx or a growing multi-speciality group located in Manhattan, a customized revenue cycle management service in New York can mean the difference between a practice thriving or surviving.

Real Results for New York Providers

Many healthcare organizations in New York have experienced dramatic improvement to their financial performance by outsourcing A/R recovery and claims resolution. Specifically, these improvements range from a reduction in the amount of A/R over 90 days delinquent to enhancements in first-pass resolution rates. Professional RCM services can provide measurable results.

Imagine the potential to move from chasing payments to growing your practice. This is what effective and strategic revenue cycle support can accomplish when customized for the New York market.

Final Thoughts

Healthcare providers in New York face some of the toughest financial and operational challenges in the country. The cost of care is rising, considerable rules and regulations govern reimbursement and reporting, and the insurance market is complicated and constantly changing. While maximizing revenue is essential for any practice, for the New York provider, maximizing revenue is often obligatory rather than an option.

With professional Revenue Cycle Management service in New York—especially Accounts Receivable Recovery and Claims Resolution Support—a practice can achieve established revenue cycle and accounts receivable goals, gain financial stability or profitability, and provide effective financial care without the barriers to progress within the billing process.