4 Key Ways to Improve Healthcare Revenue Cycle Management

‘Turning away patients in need’ is not a healthcare revenue cycle management provider’s mantra!

In fact, the core values of a healthcare organization are very distinct from any other industry. This is precisely why their strategies to improve performance are also different.

Most healthcare providers seek to improve revenue but are challenged by evolving health policies, reimbursement rate reductions, and the mandated switch to value-based healthcare models. These challenges create a significant financial burden and cause providers to change the way they bill.

To improve a hospital’s financial health, the revenue cycle providers along with hospital leaders should focus on four key areas.

Front- And Back-end Synergy

From scheduling to claims management, the healthcare revenue cycle includes two main components, front-end, and back-end. Traditionally, the whole revenue cycle used to be segmented but wasn’t really getting positive outcomes as people were only confined to their roles. However, by facilitating collaboration between patient facing front-end staff and back-end medical billing staff, the healthcare revenue cycle management process becomes a much smoother one – where one can anticipate any payment issues early on. Breaking down the silos between the two also contribute to improved performance, reduced overall costs, and it ensures that staff will gather accurate information in order to generate a seamless revenue flow.

Track Key Performance Indicators

How can you manage performance unless it is measured? How do you know that the staff is efficiently performing their assigned tasks? It starts with key point indicators and dashboards to better manage the revenue cycle process. Key performance indicators tell the story of your organization’s strategic performance. From the trend line, it can be observed if you’re going in the wrong direction or right one.  Hospital leaders should develop and track key performance indicators (KPIs). From hospitals to physicians, there are five KPIs that need to be tracked.

• Net days in A/R
• Percentage of net patient services revenue
• Claim denial rate
• Final denial write-off
• Net A/R or cost to collect

Collect Patient Financial Responsibility Upfront

Getting the right upfront information helps physicians collect more. With the rise of highly deductible health plans, providers need to have certain information from a patient upfront, prior to them making any diagnosis and or delivering care services. The same holds true when delivering a patient’s financial plan. A wide number of patients are failing to pay their bills which slows down healthcare revenue cycles. This challenge can be overcome by enforcing point-of-service or pre-service payment options. Also, hospitals can develop cost estimates by using software tools that assess how much a specific patient is expected to pay. The most preferred solution to implement is credit-card-on-file services; more patients are comfortable with this option, however, only 20% of providers offer it.

Automate Prior Authorizations and Eligibility

There is an increasing demand for prior authorizations and eligibility as it leads to reduced unwanted costs. If an organization implies a manual process to verify the patient’s eligibility, it will upraise costs. But by switching to an automated process, time costs will be potentially reduced.

Verdict

In today’s extremely evolving environment, healthcare organizations struggle to maintain margins. By implementing some of the above strategies, hospitals can help build a stronger revenue cycle management process and higher their reimbursements.

Learn how our software is saving other organizations $$MILLIONS!

If you are interested in a free demo of our AllPayor® Software, please go HERE or you can register for a FREE webinar HERE