Strategies to Improve Revenue Cycle Management
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Revenue cycle management (RCM) is a critical element in maximizing cash flow in a medical practice. With the introduction of new payment models and changing reimbursement strategies, effective financial and administrative management has become essential. Managing the revenue cycle in a healthcare facility covers various tasks such as billing and collection process, gathering and entering data about the services rendered, and ensuring full bill payment.
To stay on top of the game, physician practices need to file non-deniable claims and ensure timely collection of bills. Here are some important measures that can help tackle these challenges:
Staff Education – Educate the staff to make them understand their role within the revenue cycle. Whether billing, collection or scheduling, it is critical to properly input information because this is sent to the insurance companies. For appropriate and timely reimbursement, accounts need to be accurate and bills complete. Training staff members in the use of tools such as card scanners that identify data entry errors and billing automation can be particularly useful. All staff members play a role in the practice's revenue cycle. Whether front office staff who inform payment policies to patients and to the providers or medical billing specialists and coders who prepare charges and submit them for payment, they all need to be educated about their role and how it affects the financial state of the medical practice.
Streamline Workflow – To enhance revenue management practices, it is necessary to have a consistent workflow and align clinical and financial practices. Determining coverage, assessing payment risk and scheduling resources before the patient's arrival will enhance efficiency and increase customer satisfaction.
Communicate With the Billing Team – Physicians should not lose touch with the financial state of the practice. To improve RCM, they must be aware of how RCM processes are progressing. Automation can make this possible. Conducting biweekly meetings and ensuring remote access to the periodic reports through emails with the billing team allows review all the bills, collections and office revenue. A professional medical billing company helps physicians stay in the loop with customizable monthly reports.
Ask Suggestions from Frontline Staffs – Frontline staff may have valuable opinions and deep understanding to share and making them active participants in the process of improvement could bring big changes. If a problem is identified, ask them for suggestions to solve that problem in the best way. For additional suggestions, check back with them regularly and reexamine the practice work flow on a regular basis.
Benchmark the Healthcare Data – The process of bench marking the data will help to identify the areas of improvement in the revenue cycle. It is done by comparing the practice performance for total quality management with an external standard. This helps to reduce expenses along with improving the quality of service by helping the members of a practice reflect more effectively on their own performance. In the healthcare industry, benchmarking is proven to be extremely helpful with careful planning and research.
Data Mining – In health care, large data especially that generated by transactions may be too complex to analyze. Through data mining this large amount of data can be analyzed and
transformed
into
useful
information
for
constructive
decision
making.
This
methodology has got many benefits as it helps in detecting fraud and abuse, treatment effectiveness evaluation, identifying best practices, healthcare management, customer relationship management etc. For this, an enterprise data warehouse (EDW) can be used that combines data from IT systems including clinical, financial, patient satisfaction scores etc and optimizes it for analysis.
Payer Contract Checking – Carefully monitoring and frequent communication with the payers on contract can make a huge difference in the improvement of the revenue cycle. Use an EDW (Enterprise Data Warehouse) to check if the payers are under-reimbursing the practice, if there are too many claim denials or unreasonable patient accounting demands.
Patient Satisfaction – Patient satisfaction can be ensured by providing a caring attitude which starts from the front office. A pleasant and convenient healthcare practice will be more successful in keeping the patients engaged and loyal to the providers. This will facilitate getting correct and complete registration and insurance information essential for proper reimbursement. Providing patients with convenient and easy payment options would increase their engagement and satisfaction, which is important to an organization’s long term financial viability.
In their day to day busy schedule, physicians may not be able to manage their revenue cycle systematically. They could consider outsourcing to a professional medical billing and coding company that can manage the entire revenue cycle and allow clinicians to focus on patient care. Reliable companies offer accurate medical billing and collection services for healthcare accounts receivable management. These medical outsourcing companies are equipped with the technology necessary to automate processes and increase efficiencies, streamlining the medical coding, billing, and follow-up processes, speeding up physician reimbursement and reducing revenue loss.
Contact Us 8596 E. 101st Street, Suite H Tulsa, OK 74133 Main: (800) 670 2809 Fax: (877) 835-5442 E-mail: info@managedoutsource.com URL: www.outsourcestrategies.com