How to Increase Revenue in Healthcare

How to Increase Revenue in Healthcare

As a healthcare provider, your profession surrounds improving health and protecting lives, not worrying about your bottom line, right? 

Well, sort of. To provide excellent patient care, you need the lights to stay on. And for that, you do need to focus on the bottom line.

Increasing revenue streams and protecting against unnecessary leakage is a core component of running a successful medical practice. For actionable solutions on how to increase revenue in healthcare, read on.

#1 Offer Virtual After-Hours Visits

If your patients view you as a go-to source of information and reassurance at all hours of the day, you’re probably already conducting a few after-hours “appointments.” Unfortunately, those impromptu calls don’t usually qualify as reimbursable visits in the traditional sense.

If you’re already doing it, why not boost your bottom line by officially putting it on the books?

With virtual—rather than in-person—after-hours appointments, your doctors can maintain some semblance of work-life balance while generating increased revenue and outperforming nearby practices that only work a strict 9-to-5 schedule. 

#2 Optimize Revenue Cycle Management

One of the most effective ways to increase revenue is to reduce unnecessary loss of revenue. As the old adage goes, sometimes the best offense is a good defense.

Mounting a substantial defense requires targeting one of the primary sources of income (as well as income loss): the revenue cycle. This refers to the entire life span of a patient account from intake through to final payment. The problem is that there are several possible interruptions between these two bookends that prevent this payment from ever reaching your practice.

Optimizing your revenue cycle management (RCM) requires patching up weak spots and existing leaks to make sure the money you’re owed makes it to you.

Revenue recycle managements steps include:

  • Reduce insurance claims denials and underpayments – Getting properly reimbursed for every procedure, test, and appointment is difficult but you can’t always blame the insurance company. To minimize the mistakes made by your people, use a computerized analytics system to identify common errors and correct them going forward.
  • Pre-clear patients financially to avoid bad debt – The combination of an insurance claim denial and an insolvent patient is a recipe for disaster—for you, the provider, who doesn’t get paid for your time and services. Checking the patient’s insurance coverage and financial history before proceeding can help you avoid accruing irrecuperable debt.
  • Engage in proper billing practices – It’s important to educate both administrative staff and patients upfront about billing. For frontend staff, their training includes using the right billing forms, notifying providers about a history of financial red flags, and properly filing insurance claims. For patients, this requires full transparency about the cost of care, insurance coverage, and potential financial assistance routes.

To further reduce the chance of human error, you can also invest in an automated RCM system. 

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#3 Automate Integral Management Systems

Managing claim denials is fundamental to running a successful medical practice. And yet, about 31% of providers are still processing claims denials manually.1 

There’s a lot of money to be gained through system automation—up to $8.5 billion each year, according to the Council for Affordable Quality Healthcare.2

A few key workflows worth automating include:

  • Prior authorizations
  • Claim submissions
  • Claim payment

But revenue cycle management isn’t the only healthcare subsector to benefit from a little automated fine-tuning. Depending on the current status of your various management systems, you may want to consider upgrading several key processes with new and improved workflow technology, including the following RCM terminology:

  • Electronic Health Records (EHR) – Naturally, charting by hand is a slow and arduous process. EHRs are more efficient and leave less room for error or omissions, which creates more accurate medical coding, claims processing, and therefore payer reimbursements.
  • Contract Management System – With all your various contracts in one centralized location, you’re much less likely to miss important renewal deadlines, contractual provisions, and specific reimbursement requirements.
  • Computerized Provider Order Entry (CPOE) – This streamlined system sends instructions for prescription disbursement, lab tests, and radiology orders via a secure digital program rather than over the phone or by fax. The standardization results in less illegibility or incompleteness errors and more efficient processing. If integrated correctly with additional automated systems, it can also:
  • Identify drug interactions, allergies, and other red flags by using an interconnected clinical decision support tool.
  • Reduce insurance claims denials (and money lost) if integrated with an electronic practice management system that can alert you of orders requiring pre-approval

As a doctor, you might recommend less screen time and technology use to some of your patients, but when it comes to your practice, established software is a downright necessity.

#4 Reduce Unnecessary Patient Testing

Eliminating lab tests to save money is a difficult balancing act—holding off on testing for purely fiscal reasons is a clear ethical violation, but there are also plenty of redundant screenings performed every day.

The key is pinpointing which tests are, in fact, redundant. 

An Indiana branch of the Veterans Health Administration conducted a study that cut the number of lab tests by 11.18% with no negative patient outcomes and a yearly savings of $150,000 with the use of automated technology.<sup<3 

In this case, they used a laboratory expert system (LES) to cap testing based on certain frequency rules for each unique test. So, as an example, each patient would be allowed to receive a complete blood count every six months, a lipid panel and urinalysis every year, and a meningitis culture screening every two years. If another request was submitted within this time frame, it would be automatically declined.

Naturally, to preserve optimal care provisions, there are exceptions to every rule. These guidelines can be manually overridden by contacting the laboratory directly if there is a genuine health concern or in emergency situations. 

This new initiative didn’t negatively impact patient health but it did positively impact annual revenue by mitigating unnecessary expenses.

#5 Curb Late or No-Show Appointments

Let’s face it: life happens. There are about a million things that might get in the way of your patients’ daily lives, and a few hundred of those could result in missed appointments.

As sympathetic as you might be, you can’t ignore the effect this has on your revenue stream.

There are at least two different ways to address this kind of revenue leakage:

  • Charge a late cancellation or no-show fee – This is perhaps the more traditional and long-employed option. It means that your practice still earns the money it needs to operate, just from a different income source. But it’s also likely to alienate and drive away patients who have very good reasons for missing the occasional visit.
  • Provide virtual visits for certain appointment types – If patients don’t always have to take time off work, pay a babysitter, or drive an hour in rush hour traffic to make it to your office, they may not need to cancel appointments they otherwise would have needed to.

Of course, last-minute emergencies and unanticipated cancellations won’t necessarily be affected by a virtual appointment option, but it does provide a kinder, more accommodating alternative to busy patients with other obligations.

To really create an air-tight revenue seal, you can introduce a cancellation fee and the choice to book a virtual visit, helping out on-the-go patients while still protecting your bottom line.

#6 Renegotiate Your Payer Contracts

Far too many practices simply avoid doing this. It can be an intimidating discussion to enter into, but it can also yield several revenue-related benefits, including:

  • Higher reimbursement rates for your most popular procedures
  • A more reasonable timeline for filing claims
  • Prompt notification of any contractual policy changes
  • A favorable fee schedule

Effectively negotiating and renegotiating payer contracts is one of the most pivotal improvements you can make, although it’s also one of the hardest to enact without professional assistance.

Increasing Revenue: Let Healthcents Do the Heavy Lifting

A professional payer contract management company like Healthcents comes in handy to guide you towards what to look for in an RCM Partner or outsourcing revenue cycle management. 

At Healthcents, we handle every step of your renegotiation processes to arrive at final agreements that actually serve your bottom line, not to mention ongoing payer contract management, revenue cycle optimization, in-depth data analysis, and provider credentialing. 

Focus on providing the best possible medical care. We’ve got the rest covered. For more information, contact us today.

Sources: 

  1. RevCycle Intelligence. 31% of Providers Still Use Manual Claims Denial Management. https://revcycleintelligence.com/news/31-of-providers-still-use-manual-claims-denial-management
  2. RevCycle Intelligence. Claims Management Automation Progresses, But Opportunities Remain. https://revcycleintelligence.com/news/claims-management-automation-progresses-but-opportunities-remain
  3. Health IT Analytics. VA Clinical Decision Support Cuts Unnecessary Lab Tests by 11%. https://healthitanalytics.com/news/va-clinical-decision-support-cuts-unnecessary-lab-tests-by-11