In 2019, community hospitals alone in the US provided uncompensated healthcare totaling $41.6 billion. Despite the fact that this figure may seem large, there are many other factors that contribute to the massive debt of healthcare organizations, which negatively impacts their profitability. Now, we will show you how to deal with revenue-related problems in the healthcare sector.
Revenue Cycle Management is difficult to achieve in the changing healthcare environment. The sector has been forced to adapt to new laws and reforms. Many hospitals are now struggling to maintain their revenue under a value-based reimbursement model.
Today’s technology platforms can help consumers, payers and providers interact and communicate better, leading to a more sustainable revenue cycle management plan. To maximize reimbursements, revenue cycle managers at medical facilities should focus on a few key areas.
RCM is frequently faced with the following issues:
- Typographical mistakes during patient registration can result in insurance payers denying non-clinical claims.
- Payment denials due to incorrect medical coding procedures.
- The lack of digitalization hampers the prompt management of payments and communication between patients and providers.
- Delays in processing insurance payments can prolong the time between the patient’s visit and the payment.
These issues are still a problem for most healthcare facilities that operate across multiple specializations. These issues can be solved by using some troubleshooting methods. Here are five proven methods to improve RCM and increase production.
Best Practices for RCM
This article explores five essential strategies you can use to improve clinical workflows and revenue cycles in healthcare.
1. Take advantage of software and tools to maximize your RCM
It is best to use software and tools that manage revenue cycle management software, as well as client portals online, to streamline the client interaction and payment process. Data collection is crucial when it comes to updating services and technology. Analyzing trends in client metrics such as the frequency of visits, episodes that occur, payment rates, etc. can help your agency make data-based decisions. Centralizing all receivables data can also improve billing and payment processes.
Patients can take more control of their health by using online portals. They can check in for appointments, reschedule, view health data, pay unpaid amounts, ask for refills, and message doctors. A lack of digital solutions can slow down revenue cycles, make it difficult to communicate and connect with clients and providers, and make your business look bad.
2. Focus on a Patient-Centered approach
A patient-centered approach is another solution to how to improve the revenue cycle of healthcare.
Research shows that 49% of patients say accurate information on healthcare costs and services influences their choice of provider. Patients are more likely to use hospital services if the hospital uses modern data processing, payment, and billing methods. It has been proven that improving patient experiences, which are educational and frictionless, increases healthcare revenue.
Ensure that the entire process, from collecting information about insurance to payment, is simple and easy for patients.
In this case, it is vital to implement the right software. Patient engagement software provides, for example, automated administration tools, education modules, help modules, and improved communication channels. This streamlines hospital-patient interaction and eliminates red tape. Electronic health records (EHR), telemedicine tools, ePrescriptions, and online scheduling all help to facilitate communication between patient and provider.
3. Staff Training and Education for Medical and Administrative Staff
Hospital Revenue Cycle Management has been hampered due to a lack of training and education of medical and administrative staff. Even one mistake can cause the entire process to fall apart and reduce your chances of getting paid quickly.
Healthcare businesses should therefore educate their staff in financial concepts, and unify them across departments. A lack of training is often the cause of anomalies in financial data for patients between departments, according to research. Training will reduce the likelihood of inconsistencies and data transfers between departments.
Hospitals can use scripts, coaching, observations, and real-world situations to teach their staff how to handle financial problems when speaking to patients.
Inform your staff of the importance of new software and the ways in which it will improve standard hospital operations. You must also train your staff on the new system so that they do not waste time trying to figure out how it works.
Training in-depth for medical and administrative personnel increases employee loyalty, lowers turnover, and improves the patient experience. Increased employee retention is another strategy for optimizing healthcare revenue cycle management.
4. Set goals and monitor KPIs
We always ask billers, cashiers, and other staff about their productivity goals during revenue cycle reviews.
Employees who have goals are more motivated to achieve them. Knowing the revenue they are expected to generate will also benefit them. Billers can produce work at drastically different rates if they don’t have clear expectations. One biller might submit 200 claims per day, while the other only submits 30.
Maintaining up-to-date financials has many benefits. If your cash posters have a delay of a week, you cannot close your month-end and send financial data to those who need it for business decisions. Set goals and monitor your success to determine if you have enough employees. You can also decide if you need to simplify or adjust some procedures in order to keep cash posters up-to-date.
5. Streamline Point Of Service (POS) Collection
You have already heard about some of the adjustments that you can make to reduce denials and the need for rework at the end. Rework can also be reduced by scheduling eligibility checks, selecting the correct payer, and providing accurate information about insurance. The reduction of errors can be achieved by streamlining and modifying processes, as well as educating employees on the new procedures.
We recommend that you also organize the collection of POS data. Collect copays or money from patients before the service. It can have a major impact on your revenue cycle.
This post was written by Physicians Choice Medical Billing, LLC. Physicians Choice Medical Billing, LLC has been providing exceptional, and comprehensive Full-Service Practice Management including medical billing, coding, revenue cycle management, credentialing and consulting services to our clients. Whether you are a new startup or an established medical group, PC has the experience and dedication to make your practice a financial success. The staff bring multiple years of experience and dedication. Fingerprinting in Tampa and Fingerprinting in St Pete with Physicians Choice provides the highest quality, professional digital Live Scan fingerprints in a comfortable professional office atmosphere. Physicians Choice offers both individual and corporate account service.