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What Are the Features of RCM Software?

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Your revenue cycle ensures your claims to payors are valid and get paid on time. Tracking patient data from start to finish allows you to accurately document every encounter, medication, and treatment administered so you can efficiently submit claims. Revenue cycle management (RCM) software should help you take control of your revenue cycle and optimize claim submission and payment processing through electronic claims submissions. What features of RCM software can benefit your practice the most?

Sunwave Health’s RCM platform seamlessly integrates with other business functions, like electronic medical records (EMRs), to accurately document every aspect of patient care. Plus, you’ll be able to utilize more than 150 validation rules for behavioral health treatment—on top of your own custom rules— to automatically validate claims. Call 561.576.6037 to schedule a demo.

Understanding RCM Software

Revenue cycle management software serves as the financial backbone of healthcare organizations, streamlining processes from patient intake to final payment. For behavioral health treatment centers, where patients often transition between various levels of care and have complex billing needs, having reliable RCM software is crucial. The features offered by RCM software greatly benefit practices by improving efficiency and accuracy in claim submissions and payments.

Essential Features of RCM Software

Automated Billing and Claims Processing

The automation of billing and claims processing is pivotal, reducing human error and accelerating the reimbursement cycle. This feature ensures timely submissions and enhances the likelihood of first-pass claim acceptance, directly impacting the bottom line.

Eligibility Verification

Real-time eligibility checks are crucial for confirming patient coverage before services are rendered. This preemptive step significantly lowers the rate of denied claims, ensuring that services provided are covered and payment is secured.

Charge Capture and Coding

Accuracy in charge capture and proper coding is fundamental for compliance and reimbursement. An RCM software’s sophisticated coding capabilities ensure that charges are captured correctly for each service provided, adhering to the latest coding standards and regulations.

Payment Processing and Reconciliation

The complexities of payment collection and account reconciliation are simplified through the RCM platform. This ensures that payments are processed efficiently, accounts are up-to-date, and the financial standing of the facility is accurately reflected.

Utilization Review

Having a comprehensive view of therapy minutes and services rendered is vital for optimizing reimbursement. RCM software offers utilization review tools, allowing practices to monitor treatment sessions and ensure that patients are receiving the best possible care.

Reporting and Analytics

Data-driven decision-making is empowered through comprehensive reporting and analytics features. These tools offer behavioral health providers visibility into their financial performance, identifying strengths, pinpointing areas for improvement, and guiding strategic decisions.

Advanced Features to Look For

Integration with Other Systems

Seamless integration with EMRs and telehealth platforms is essential for efficient and accurate documentation of patient care. This eliminates the need for manual data entry, reducing administrative burden and potential errors.

Customizable Rules and Alerts

RCM software that allows for customization of validation rules and alerts enables practices to cater to their specific billing needs. This feature helps ensure compliance with regulations while improving claims accuracy and preventing denials.

Customizable Reporting

The ability to customize reports allows behavioral health facilities to tailor financial analyses to their specific needs. This flexibility is invaluable in extracting relevant insights and driving informed decisions.

Schedule an Online Demo with Sunwave Health

Behavioral health providers have unique billing needs and requirements that deserve a specialized revenue cycle management solution. Sunwave Health’s RCM platform offers all the essential features plus advanced capabilities to take your revenue cycle to the next level. To learn more about how our software can benefit your practice, schedule a demo online today or call 561.576.6037.