Gone are the days when revenue cycle management was simply about collecting payments from patients. Rather, it is now an essential tool in any healthcare organization’s marketing strategy to amplify all sources of revenue. Among these sources are private medical insurance, government funding (Medicare, Medicaid, CHIP, and military health insurance programs), and patient out-of-pocket payments. A few private hospitals and clinics are also able to generate income from investments, donations, and grants. In this context, it raises the question of how RCM plays a role in maximizing revenue.
There is no denying the fact that revenue cycle management is a vital part of any hospital’s financial health. The reason is simple: If a clinic or hospital’s revenue cycle is optimized, then it will face higher margins, and if not, it will face significant losses. Complications such as billing and coding errors, patient misidentification at the front end, and miscommunication can lead to denied claims and delayed payments. Ultimately, the patient volume won’t matter if a hospital takes a long time to capture revenue or faces denied claims.
A report by the June 2022 National Hospital Flash Report indicated that hospital margins were “cumulatively negative” because hospitals are still performing below pre-pandemic levels. Therefore, as a roadmap to financial recovery, in this blog, let us examine a few strategies that can help optimize the Revenue Cycle Management cycle.
- Deliver a Patient-Centered Approach:
There is great room for automation in the healthcare revenue cycle. To get reimbursed accurately and quickly, revenue cycle management team members perform several highly repetitive tasks (such as eligibility verification, claim status follow-up, and patient statement creation). The use of technology can automate these types of tasks, allowing team members to focus on more complex, value-adding activities. Patients are more likely to use its services when a clinic or hospital uses current data processing, billing, and payment methods.
This way, with workflow automation, you can ensure that all procedures-from gathering insurance information to making payments are simple and practical for patients and also generate profits on time.
- Keep up with recurring updates regularly:
We discussed how healthcare is constantly evolving. Depending on how you are generating revenue, you could be getting it from multiple channels, as mentioned before. As a result, it is essential to review your daily processes regularly to ensure your revenue cycle management is working smoothly. Although many other work-related events occur daily, and addressing issues once they occur may be more accessible, it is safer to optimize revenue cycle management by checking on and updating technological processes regularly rather than waiting for them to occur.
In order to accomplish this, there are many options available. For example, it is essential to train the front-end staff on total medical costs and patient care. Therefore, when patients receive their medical bills, you can prevent last-minute surprises affecting payment facilitation. In the same vein, online patient payment options enable patients to make payments quickly and effortlessly. These days, increasingly, patients are seeking faster ways to pay, such as online payment methods (check out our expEDIum Direct Pay option here). Providing patients with simple and quick payment systems is crucial to optimizing the revenue cycle and maintaining its health.
- Outsourcing to a billing partner:
Regardless of the size of the healthcare organization, seeking professional assistance is a wise decision. Most healthcare-associated companies provide two types of services when it comes to outsourcing. It is either billing software or services that they provide. Also, it is possible for some companies to provide both to their clients as well.
A revenue cycle management outsourcing service would be ideal for addressing the delays in reimbursement, lack of adequate technology, and amateur workflow. As a result, it facilitates internal operations and creates a high level of transparency. It is imperative to select a partner with extensive knowledge of the organization’s specialty and experience in integrating with current systems and support systems.
Since the outsourced team handles most of the staff’s administrative work, billing, coding, and other associated duties, the staff can focus on providing value-added services to the patients.
“We are a small behavioral health provider in Georgia and have had difficulty finding a billing solution that provides prompt payment by insurance companies and an integrated billing solution for an affordable rate,” claims Jessica W Epps, the Clinical Director of Steppingstones to Recovery®, LLC after using our expEDIum billing solutions. She also went ahead to add that “We have never had claims paid so consistently before using the expEDIum billing solution and claims portal!”
To improve your organization’s performance, you must adopt strategies for optimizing your revenue cycle management. A clear articulation of the process to patients, implementing online payment technologies, automating workflows, and adequate staff training are all important. When you outsource to a reliable partner, you save time and exasperation and reduce your team’s time on less critical tasks. If interested, try our revenue cycle management services or contact us here, as we can help you stay financially healthy.
