As you enter into more capitation contracts, manually keeping track of the constantly changing list of eligible beneficiaries can be a significant burden on your revenue cycle management (RCM) staff.
Underpayments and overpayments are two of the biggest issues for organizations that participate in capitation arrangements. Underpayments can lead to cash flow problems for your practice, while overpayments can result in the need to repay funds months or even years after they were initially received. With manually reviewing eligibility lists every month, the risk of errors increases, and staff burnout is a real concern.
But it doesn’t have to be this way. By implementing software that automates eligibility verifications, you can simplify the process and ensure that your PMPM payments are accurate and up-to-date. Here are some of the key features to look for in such a solution:
By implementing a flexible claims process solution, you can overcome the challenges of keeping your member enrollment and eligibility lists current and ensure that your PMPM payments are accurate. The result will be a smoother, more efficient RCM process and improved financial stability for your practice. Don’t let the challenges of capitation payments keep you from advancing in value-based care. Invest in a solution that will help you stay ahead of the game and stay focused on what really matters: providing quality care for your patients.
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