Most healthcare executives will agree that the revenue cycle for large health systems is the most complex of all industries. From scheduling to collections and every step in between, the healthcare revenue cycle is ripe with opportunities for improvement. Focusing on three key areas – speed, cost, and accuracy – is the key to improving the health of your revenue cycle.
They say patience is a virtue, but when it comes to running a costly health system, waiting around for payment is a luxury most hospitals can’t afford. Between decreasing reimbursement, shrinking margins, and a complex regulatory landscape – healthcare organizations should be focused on initiatives designed to reduce the time it takes to get claims out the door and to receive payment in hand. There are numerous steps throughout the revenue cycle where a focused effort can reap real rewards. To start, communicating patient responsibility and setting expectations about up-front collections’ policies and processes for the collection of self-pay fees can improve the speed of your revenue cycle. From there, ensuring claims are submitted promptly and ensuring your denial management team is top-notch, can help decrease the time spent on your revenue cycle. Lastly, using advanced technologies to provide your RCM teams with real-time trending can help organizations isolate and prevent future denials – leading to long-term improvements to the speed of your revenue cycle.
Cost is Key
For healthcare organizations, cost containment is a key strategy for improving revenue cycle metrics. When it comes to reducing costs, revenue cycle management teams need the perfect balance of people, process, and technology. On the people side, strong leadership is critical – and RCM teams must be supported by exceptional medical coding and billing teams. Many organizations choose to use a hybrid model for medical coding and billing, to include a lean staff that partners with a team of outsourced medical billing and coding experts. This reduces overhead by lowering payroll expenses; decreasing equipment, office space and technology costs; and saving money associated with employee benefits. Process is about streamlining your efforts and reducing rework, which will always help reduce costs. Not sure where to start? Chances are that your strongest leaders and team members have ideas on where you can improve processes. Finally, organizations can reduce costs by using technology to save time and improve efficiency. Using a comprehensive coding workflow software that uses business intelligence can enhance coder performance, and on the back-end, using an intelligent coding audit software can give greater insight into your organization’s opportunities for improvement.
Accuracy is Everything
Healthcare organizations know that accuracy is critical at every step of a patient’s encounter. While usually, performance improvement efforts in a hospital are focused on clinical accuracy, revenue cycle accuracy also plays a key role in the patient experience. Likewise, accurate documentation and coding not only support a healthy revenue cycle, getting it right is important to your patients – and can have an impact on the quality of care and the patient billing process. That’s why monitoring and auditing these processes is important – and the sooner it can be done, the better. While organizations have historically performed coding audits after the encounter, savvy organizations are now using more timely methods such as concurrent review processes and pre-billing audits to ensure accuracy throughout the revenue cycle – rather than on the back-end only.
Maximizing your revenue cycle by carefully evaluating and optimizing speed and accuracy, while also focusing on reducing costs – you can set your healthcare organization up for long-term success.
Not sure where to start? GeBBS Healthcare Solutions has decades of expertise helping healthcare organizations improve their revenue cycle. We’re proud to offer a no-cost analysis of your accounts receivable (A/R) metrics to help you benchmark your performance against similar systems. Visit gebbs.com or click here to learn more.