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Healthcare Revenue Cycle Management: 12 Things to know

The healthcare landscape is growing very rapidly. At the same time, the challenges that physicians face are also rising too. Some of the challenges that they were once told they would face including rising costs, low reimbursements, staff turnover and may more complex requirements are now here. The time has come to re-think the ways in which healthcare leaders manage the revenue cycle management process.

From bringing little innovation, to improving the bottom line, here are 12 things to know when it comes to revenue cycle management:

  1. Reimbursement

It is one of the highest priorities for healthcare service providers. In fact, on average, CMS (center of Medicare services) rejects 26% of the claims it receives while 40% of these rejected claims do not even go for resubmission. From this data, it can be seen that the lost revenue is about 10% per claim. Thus, health care staff will save money and resolve this issue by adopting a trusted and reliable RCM vendor.

      2. Market Growth

According to MicroMarketMonitor, RCM holds an immense growth potential by 2019. The accelerated cash flows, reduced costs and improved productivity are responsible to drive their market.

      3. Net Collections

RCM enables health personnel to keep records in many ways, such as patient pre-visit data checking, claim submission, payment posting and reconciliation. It proceeds all the way through the financial reporting. This whole process is very effective. Also it proves to show net collection of 98- 99%.

     4. Right Capital Structure

Gone are the days of frothy capital markets. Keep in mind the changes in the healthcare environment and financial services, it is also suggested to rethink about the capital structures of healthcare.

     5. Consolidation And Integration

There is an enormous amount of consolidation and integration that needs to take place. Healthcare decision builders and leaders should think about ways to better communicate and integrate with their organization. They should go-ahead and take better initiatives with physicians and especially patients.

    6. Outsourced Revenue Cycle

With the aim to improve financial outlook, many healthcare systems are outsourcing. Healthcare providers together with their RCM partners think on innovative strategies. This can substantially be cheaper and more efficient. Moreover, it also helps in improving the bottom-line. It reduces the risk of inappropriate technology and techniques. Ultimately, it depends on your needs of your organization.

  1. Consumer-Induced Market

The healthcare providers today rely on working in consumer induced markets. They need to introduce more personalized services to the patients. Increasingly, they need to up the level of immense care. By collaborating with right RCM partner, health personnel can leave all financial burdens of healthcare behind and focus more on patient care.

  1. Patient Payment Funnel  

While processing a patient’s payment, health care providers need to implement a comprehensive, integrated and easy to use system. It is seen to reverse the negative trends with reliable RCM.

  1. Pharmacy Being Source Of Revenue Generator

Luckily, health system leaders can avail pharmacy to evolve their health care business to stay in-line and lead. They can invest on increment providing areas like ambulatory, specialty and mail-order pharmacy services.

  1. Transparency In Price

Revenue cycle is much more than just filing. It starts from the time of making a call to schedule a meeting by patient till their payment balance is completely settled. By hiring reliable RCM vendor, you can increase revenue and decrease write offs. Increased transparency and simplicity will be achieved by handing over the billing related tasks to their respective experts.

  1. Niche- related RCM vendors

There are many RCM vendors who are niche- specific. Some would only prefer to handle billing claims while others offer coding services only. And there are some RCM vendors who are providing specialties and solutions in all three areas such as billing, coding and collection.

  1. Consumerism

Average medical practices are time consuming, costly and frustrating. While RCM helps to establish an interactive and engaging experience for patient.

Thus, make a switch to appropriate Revenue cycle management partner now and leave all  the challenges behind!

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