Top 8 Revenue Cycle Management Strategies
Revenue Cycle Management
Providers miss out on millions of dollars of revenue every year due to inefficient revenue cycle management practices. Administration, medical coding & billing, and many more pieces of the healthcare practice work together to drive the practice’s growth. A slight error or malpractice can greatly disturb the complete revenue cycle. If it continues, it will become difficult for the practice to survive in this competitive healthcare industry environment. We have laid out the recommended 8 successful revenue cycle management strategies as suggestions to follow:
Verify Patient Eligibility
It is especially important that providers verify insurance eligibility during pre-registration to ensure that insurance companies will reimburse the healthcare organization for medical services provided. The top reason for claim denials is eligibility issues. Many providers out there don’t fully check patient eligibility and insurance coverage before treatment begins which in turn makes the collection process difficult and disturbs the complete revenue cycle of the practice. It is wise to choose a practice management system and EHR that offers real-time patient eligibility verification so you can save your practice from dealing with such hassles.
When a health system has multiple clinic locations, consistency in co-pay collection often falters over time. To regain lost traction, create easy reference sheets with standardized documentation of the proper co-pay workflow, noting particular transaction codes needed for correct system posting. Across the health system, create and distribute a monthly report on the rate of co-pay collection per clinic location. The monthly reports will hold each clinic accountable by direct comparison to their peers and the national benchmark for co-pay collection, which is 98 percent of all scheduled appointments. Consider a quarterly prize competition that awards the clinic location with the most improved rate of collection to reach your organization’s goal.
Error Free Clinical Data
Clinical data is the place where most errors arise because it is highly dependent on manual data entry is unlikely to be error-free. There is always a chance of error when it comes to clinical documentation but we can significantly reduce the error ratio by automating our clinical documentation. So, if you want to keep your revenue cycle smooth, then it is highly recommended that you use integrated practice management systems and electronic health records software to automate the clinical documentation process. A comprehensive practice management solution reduces the data entry burden and makes clinical documentation smoother and much cleaner. From improper ICD-10 coding to a missing signature on a patient’s charts, claims can easily be denied based on technical or clinical problems.
Efficient Billing Unit
Your administrative and clinical staff should be open and transparent about medical billing. It is wise to train your administrative staff to effectively communicate medical billing information to patients so they can have prior knowledge of treatment costs. This, in turn, will simplify the collection process and help to maintain the revenue cycle of your practice. One extra tip is to have maximum payment options at your facility so your patients can easily pay their bills. Be open to taking cash, check, and also give credit card payment options to your patients. All of these efforts will improve the reimbursement rate and keep the revenue cycle smooth. Many claim denials can be avoided by training staff on completing upfront tasks, such as using billing forms and talking to the patient about medical costs.
Real-Time Claims Monitoring
Providers should closely monitor the claim submission to reimbursement process so they can point out any errors quickly and then take steps to rectify it as soon as possible to ensure timely payments. Whether you have outsourced your billing to a medical billing company or have an in-house staff there to perform this job, real-time monitoring is essential in both scenarios so you get paid in a timely manner.
When a bill for medical services is not entirely covered by insurance or other payers, patients are responsible for paying the remainder and providers must work with patients to collect. But patients often are confused about what’s required of them and what options they have. So, it’s essential that providers immediately engage with patients to help them understand what they owe, identify primary or secondary insurance, consolidate bills, and set up payment plans.
HIPAA and Revenue Cycle Management
Hospitals and providers must always maintain HIPAA and HITECH compliance. It is recommended that you invest enough resources to safeguard confidential patient information. This investment not only maintains the trustworthiness of your practice but will save you from heavy penalties that are imposed for failing to comply with these regulations. HIPAA and HITECH compliance is essential to keeping the revenue cycle of your practice smooth.
Data Analytics for Revenue Cycle Management
Big data analytics has helped healthcare organizations manage large volumes of information and inform employees of revenue cycle management goals. Analytics can also help to predict claim results by tracking its lifecycle.
E2E Medical Billing Services try to implement these strategies for all our clients. Our efficient medical billing and coding team will ensure error-free timely submission of claims along with verifying patient eligibility, real-time claim monitoring. To know more about our medical billing services call us at 888-552-1290 or write to us at [email protected]