Any healthcare organization’s financial success is directly tied to the ability to perform successful revenue cycle management (RCM) in a continually changing healthcare landscape. This intricate process begins with the appointment booking and wraps up with the final payment receipt, but what happens in between includes a variety of administrative and clinical functions. Deeply understanding the revenue cycle management process and how to maximize it is key to ensuring your healthcare organization thrives and can continue to provide excellent patient care.
Understanding healthcare revenue cycle management is no easy task, especially for busy healthcare providers and administrators, but knowing a few ways to begin improving your practice’s financial health is a good place to start. Here are 10 of our top tips for effectively managing your revenue cycle with the help of a healthcare industry expert like PayrHealth.
Update Patient Registration and Verification of Benefits
A critical stage in the revenue cycle starts with verifying patient benefits during the registration and appointment scheduling phase. If you haven’t already, consider digitizing these processes by having the patient provide their info well ahead of their appointment, giving your healthcare providers time to process it. An even more cost-saving measure is to automate the patient eligibility verification process, saving your team time checking with health insurance companies.
Ensure Accurate Coding Practices
Coding for services rendered is the backbone of your revenue cycle management process. Ensure your coding department has the appropriate training needed and can support timely and accurate claims processing – after all, errors will only extend your reimbursement timeline. If you need extra support, consider contracting with an outsourced coding and billing department.
Support Claims Processing
Claim denials can directly negatively impact your revenue cycle. The best way to minimize claim denials is by supporting your team throughout their billing processes. Take time to learn their challenges and explore solutions so that claims can move quickly through the entire revenue cycle process. This can help you identify any leaks that might be impacting your financial health.
Proactive Claim Denial Management
Claim denials are unavoidable, even with your team’s best efforts. However, effective claim denial management can help ease the process. Effective claim denial management includes:
- Understanding typical reasons for claim denials
- Implementing workflows to minimize claim denials
- Regularly reviewing processes and ensuring adherence
It should also include proactive corrections, which may mean leaving capacity for your team to address claim denials in a timely and effective manner. One major cause of revenue leakage for healthcare organizations is unmanaged claim denials, making this an essential area of concern.
Embracing Innovation
The right tools can transform your entire revenue cycle. Electronic health records (EHRs) are essential and allow you to streamline the entire claims submission and medical billing processes – as well as during healthcare services and appointments. Artificial intelligence is another fast-growing tool that can relieve the burden off your healthcare providers by helping schedule appointments, answer questions, and even verify insurance coverage. If you haven’t invested in upgrading your technology as it relates to revenue cycle management, consider doing so.
Prioritize Patient Satisfaction and Value-Based Care
Clear communication about your patient’s financial responsibility and straightforward billing practices add to the health of your revenue cycle. When patients clearly understand their medical services, costs, and payment options, they’re considerably more likely to deliver on their obligations, as well as feel satisfied with their choice of healthcare provider. Taking a patient-centric approach means shifting your healthcare organization toward value-based care and prioritizing patient satisfaction before anything else.
Manage Accounts Receivable (A/R)
Your healthcare organization’s financial outcomes can also be dependent on patient responsibility. Take time to analyze patient payment processes and see where payment posting could be automated or supported. This can give you valuable insights into where software solutions to expand patient access could help your financial stability.
Ongoing Training Investments
The healthcare industry is dynamic, with regular changes in guidelines and coding procedures happening every year. Ongoing staff training helps your workforce stay informed about industry changes, reducing the chances of mistakes throughout the claims submission process. Although it comes with an up-front cost, you’ll find that your revenue cycle performance only improves.
Utilize Data Analytics
In this modern era, data analytics are essential to the success of a healthcare business. Tracking the performance of your revenue cycle can help you see that the above tips are producing noticeable changes and resulting in revenue generation. Conversely, they can help you see what isn’t working. Revenue growth is almost always a key performance indicator (KPI) and should be measured along with more specific things like claim denials, patient satisfaction, and more.
Consider Outsourcing
Outsourcing to a medical billing expert can be one of the most effective revenue cycle management tools. A healthcare industry expert like PayrHealth can provide medical billing and coding services along with helping you find ways to optimize revenue cycle management processes. Many healthcare organizations require significant oversight, and having a team of experts with combined decades of industry experience can lead to revenue cycle management success more than any other change your team can make.
Healthcare Revenue Cycle Management with PayrHealth
Optimizing financial outcomes with revenue cycle management is difficult, especially without a team of experts to support your healthcare organization. At PayrHealth, we can take full stock of your revenue cycle and help you find ways to transform it from initial appointment to final payment. Contact us today to set up a free consultation and learn more.
