Strong revenue cycle management is crucial in the healthcare industry. Several obstacles can impact your practice’s bottom line, including complex billing procedures, underpayments, insurance discrepancies and coding errors. A revenue cycle management solution is crucial to overcome these challenges and achieve financial stability. In this chapter, you’ll learn the benefits of revenue cycle management in healthcare and how to improve your revenue recovery strategy.
The primary objectives of the revenue cycle include patient satisfaction, improved operational efficiency and above all, improved revenue optimization. The right patient revenue cycle management solution can help you achieve these goals and more. Here are a few benefits of a strong revenue recovery strategy:
Collections is the most important part of revenue cycle management. Healthcare facilities have many expenses to account for, including services they provide to patients and paying staff for the work they do. A revenue cycle management system can help your organization receive payment for these services.
When claims are denied or patients cannot pay for services upfront, it can delay payments and make it challenging to manage expenses. To prevent this, RCM helps you uncover patterns of claim denial so you can avoid them in the future and receive timely reimbursement. Over time, the right healthcare revenue cycle platform can result in millions of dollars in additional revenue for the average hospital or physician’s office.
One of the most significant benefits of automation in RCM is the ability to save time. Effective RCM can streamline processes, from insurance verification to engaging with patients about their bills. With less time spent manually preparing bills, submitting claims and collecting payments, you can accelerate the collection process. When patients make appointments, your administrative staff must ensure the appointment is scheduled, update information and, most importantly, verify insurance. A healthcare revenue cycle platform streamlines these front-end tasks so your administrative staff can work more efficiently. Plus, automating RCM workflows ensures administrative tasks are completed accurately to prevent claims from being denied in the future.
Strategic RCM can catch the root cause of errors in your claims and billing processes while enhancing the financial health of your organization. For example, automated tools can eliminate errors due to manual data entry, increasing the likelihood that your claims are accepted on the first submission. Additionally, a strong RCM system can verify insurance eligibility in real-time, catching potential issues before services are provided to reduce claim denials and timely reworks. Integrating your RCM software with your EHR can ensure accuracy, consistency and updated data exchanges across your systems. Ultimately, this can minimize errors caused by duplicate data entry or outdated information.
With less time commitment and a lower risk of errors, a revenue cycle management platform can reduce the costs associated with managing your revenue. Proper insurance verification results in fewer claim denials, reducing the administrative costs associated with processing and reworks. It also helps you allocate resources more efficiently to save on staffing costs. Lastly, faster reimbursement turnaround times can lead to improved cash flow and reduce the need for loans or additional finances, helping you save on potential interest payments. With automated revenue cycle systems, you can efficiently follow up on unpaid bills, minimizing the associated collection costs from overdue accounts.
The goal of RCM is to streamline the revenue process so health systems can focus more on delivering quality care and providing a better patient experience. Effective RCM allows providers to focus less on administrative tasks and more on providing personalized, targeted healthcare to improve outcomes for their patients. Automated tools can also simplify processes like filling out intake forms and submitting payment. Above all, patient payment estimation tools ensure patients aren’t caught off-guard paying out-of-pocket expenses later down the line.
Improve your practice’s revenue cycle management with the following tips:
Start by analyzing your current claims and denials. Knowing how many denials you have makes it easier to choose the areas you’ll need to target and prioritize. Track them by reason and root cause to see where corrections might be needed and where to start addressing issues.
It’s also important to have productivity standards when improving your RCM. Billers, collectors and other back-office personnel should understand the amount of revenue they are expected to bring in so they are more motivated to achieve those standards. Try to keep your financials up to date and track progress to determine whether you’re properly staffed and if you need to change processes to ensure your cash posters are up to date. Knowing your numbers can make it easier to identify potential issues before they become a problem.
Another way to improve your revenue cycle management is through workflow automation. All your team will need to do is identify where technology will make the biggest impact on their RCM workflows. You might automate the following processes:
Increase your chances of capturing payments by offering different types of payment options for patients. These might include credit and debit card payment capabilities, touchless payments, digital wallets, QR codes and patient payment portals in addition to cash or checks. These payment options can ensure patients don’t have to be onsite or pick up the phone to pay, increasing convenience and making it easier for your office to easily and quickly collect payments before or immediately after providing care.
One of the most crucial steps in improving RCM is training your administrative staff on the intricacies of revenue management, including patient payments. When possible, automate aspects of the process to reduce your team’s time burdens. Healthcare is constantly changing, and knowledgeable staff will be prepared to adapt to regulation changes that affect billing and address them before they can negatively impact your RCM.
A strong RCM strategy is crucial for any healthcare practice. At Millennia, we use digital patient engagement to make it easier for patients to understand and pay their bills so that we can improve patient revenue. Request a consultation to learn how we can help you improve your revenue cycle management process.
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