How to overcome the common issues in Revenue cycle management

Revenue cycle management is the vertebrae of a profitable medical practice. Many physicians struggle with the idea that they are both businessmen and medical practitioners and are constantly looking for ways to improve practice operations. Most hospitals and healthcare systems across the United States are experiencing a significant increase in cost associated with the revenue cited. According to research conducted by McKinsey, 15% of every US healthcare dollar spent goes towards revenue cycle inefficiencies. Around 400 billion dollars of the country’s annual healthcare fund goes to claiming processes, payments billing revenue cycle management, and bad debt. 

Challenges in Revenue Cycle Management 

Hospitals and Healthcare systems are constantly challenged to maintain a strong revenue cycle amidst fluctuating industry dynamics. Along with staying up to date with the Affordable Care Act, Medicaid, and other healthcare programs. Healthcare providers need to have effective building and tracking procedures in place if their practices have to be successful. Practice leaders are under pressure and have to speed up cash flow, reducing the cost to collect and maintain regulatory compiling and responding to the new and emerging payment models.

• Ineffective building and collecting process.

An ineffective billing and collecting process can cause the health care professional thousands if not millions of dollars. Suppose you fail to collect accurate information upfront during the patient’s scheduling and patient registration. In that case, there will be errors in ICD 10 coding and declining in verifying insurance eligibility, which can negatively impact the revenue cycle. The patient’s financial responsibility has a large impact on the hospital revenue cycle.

Patients may leave bills because they are uninsured, underinsured, or know there is little price transparency, and the bills they receive are confusing. Through effective estimating, communicating, and collecting from patients, the hospital should collect the right information for the first time at the point of service while patients are still there. 

• Lack of staff education.

Inefficiency in revenue cycle management also results when the staff is not trained and how the rules fit into the overall revenue, citing the front, collecting, processing, and tracking patient data. Incorrect information processing can result in proper medical coding, building and insurance claims being filed. Such errors can cost the practice a lot of money.

• Communication between the physician and financial managers. 

If the lead physician in the medical practice is not involved in the revenue cycle process, they become disconnected from the financial state of the practice. These small problems can escalate into large ones and tensions when you think about the loss related to rejecting claims and unaccounted payments in slow turnaround.

Tips to Improve Revenue Cycle Management 

Many opportunities can improve your revenue cycle management. These improvements might seem expensive and time-consuming, but these time changes provide a bigger impact.

• Digitalization.

A digital solution is an answer to track streamlining patient communication and payments. Using cloud-based revenue cycle management software can help combine invoice and payment transactions, claims filing, appointment scheduling, etc., all in one convenient space.

• Easy pre-admission.

With any service going the extra mile for the customers, it will always create a good workflow when it comes to pre-admission or making contact with patients before the actual day of admission. It allows them to enquire about anything or raise concerns that they may have. Since you are a medical staff handling all the free admission communication, you are responsible for identifying any obstacles during the process. You must achieve as much as possible before the patient’s arrival, even taking it to the next step, verifying the contact information, and potentially taking payment over the phone. These simple upgrades from the front-line team can create a big difference.

• Hire a designated care coordinator.

Care coordinators can understand the transaction of value-based reimbursements by keeping up to date with legislation and policy changes and measuring the organization’s quality of care and efficiency. They also serve as mediators between patients and providers by helping the management better understand the patient’s concerns. The care coordinator makes sure the patients receive great care. 

• Track performance.

To have a successful revenue cycle management, it is not only needed to be mindful of the organization’s payment but also to keep track of errors while filing claims. It measures the rate and statistics in setting goals to assess the efficacy of the workflow; you can figure out if things are not going in the right direction and consider how to make things turn around and manage the workplace and the resources.

•  Enhancing patient financial expenses. 

Take small steps to improve the patient payment system, including mailing them before admission or verifying valid contracts. Offering multiple methods of payment such as credit or debit online portal payment plan, etc., will improve patient experience.

Takeaways

Most hospitals and Healthcare practices recognize that they need to prioritize their revenue cycle management. According to research conducted by The Market Reports, the Global Healthcare revenue cycle management will significantly increase in the coming years, rising from 11.7 billion dollars to 23 billion dollars by the end of 2023. To deliver on the mission of providing high-quality patient care, outsourcing is one of the best ways to overcome the challenges of RCM and the healthcare staff can focus on what they do the best. To get started with outsourcing, reach out to Sixapart Healthcare. Let us handle your revenue cycle management with ease!