The healthcare industry is evolving rapidly. To keep up with the advancements, the revenue cycle management process also needs to be improvised and adapted accordingly. Ranging from patient appointment setting to medical billing and coding, the process efficiency must be prioritized to carry out a frictionless healthcare RCM process.
The following are the improvements that a medical practice can employ to optimize their revenue cycle management:
Automating Key Processes
Investing in healthcare revenue cycle technologies is beneficial for medical practices since the key steps such as pre-authorizations, denial management, claim submission etc. can be automated. Automation helps streamline the healthcare revenue cycle workflow and enhance its efficiency. This would prevent manual errors, decrease administrative burden, save time and costs for the medical practice. The seamless integration of these RCM technologies with the existing systems of the healthcare providers enables a smooth healthcare revenue cycle process. These technologies also increase payment convenience for the patients, to enable them to receive payment notifications and pay their bills online.
Ensuring Complete Payment Collections
Healthcare practices need to start collecting payments from their patients during their pre-admissions. The patients can be given a confirmation payment form to validate their payment plan. This kind of documentation would guarantee complete payments for the medical services utilised by the patients. In addition to securing patient payment confirmation, the healthcare providers need to manage claim denials effectively. Some of the steps to achieve effective denial management would be to re-submit claims after eliminating errors and following-up with the payers regularly. Therefore, tracking patient payments would help medical practices to keep their collections in check. It would also prevent the patients from slipping away without completely paying their bills owed to the healthcare practice.
Tracking the KPIs
Healthcare providers can improve their revenue cycle management by measuring their existing RCM performance statistics. They can do this by effectively tracking their Key Performance Indicators which include, claim denial rate, revenue collections, A/R days, etc. The measured KPIs would provide the detailed insights on the financial health of the medical practice. Through these key performance metrics, key areas such as existing workflow, protocols etc can be improved. These areas can be updated by comparing them to the current performance benchmarks. This data can be utilised to eliminate the potential bottlenecks in the healthcare revenue cycle.
Blending the Front-End and Back-End Processes
The front-end and back-end processes are different from one another but must synchronize and work together to prevent errors during the RCM process. The various front-end processes include direct contact with patients such as patient registration, eligibility verification etc. Back-end tasks do not require direct contact with patients and consist of denial management, medical billing etc. The front-end and back-end staff need to communicate and collaborate with one another, to better understand the revenue cycle management process. By removing the front-end and back-end segmentations, the knowledge gaps are erased, resulting in an improved healthcare revenue cycle process.
In addition to all the above measures, some medical practices choose to outsource their RCM needs to renowned third-party revenue cycle management companies. These companies leverage their experience and expertise to improve the healthcare revenue cycle for the medical practices. They also maintain process transparency pertaining to total payment estimates for the patients and the RCM process details. They stay updated with the changes occurring in the healthcare industry. When all these are properly taken care of, medical practices can improve their healthcare revenue cycle process.
Increase their clinical and financial performance