Revenue cycle is one of the most critical functions of a healthcare organization. Hospitals and health systems are constantly striving to improve RCM functions to maximize revenue and drive organizational efficiency. Teams can focus on these 10 tips to improve RCM processes:
1. Optimize Patient Intake and Scheduling
Accurate data collection during patient registration minimizes downstream billing problems. To achieve this, use an electronic health record (EHR) to establish your new patients as they start working with you to streamline the process. Clear communication with patients from the onset enables your business to minimize time consuming conversations later. Be sure to talk about insurance coverage they do and do not have, as well as financial responsibilities.
2. Automate Insurance Verification and Eligibility
Automation minimizes mistakes humans make, no matter how accurate they seem to be. Automated insurance verification tools reduce administrative burdens, but they also ensure only accurate information is added to your patient files. You will need to update insurance information over time. And, of course, be sure you communicate with patients about their insurance needs and limitations.
3. Ensure Accurate Coding practice
Accurate coding is at the heart of effective revenue cycle management in healthcare. Improper codes led to claim denials and, ultimately, a lack of reimbursement. If you are using in-house professionals for this task, ensure they have the most up-to-date training and are using advanced coding software tools to minimize these common, costly errors.
4. Streamline Claims Submission Process
Implementing strategies to automate the claims submission process that minimize the manual process also reduces errors. In this component of revenue cycle management, you’ll see efficiencies improve as well, which overall impacts your healthcare organization’s bottom line. The use of clearinghouse software can minimize risks because it ensures the claim meets the required formatting before reaching the payer. This also ensures compliance.
5. Implement Proactive Denial Management
Organizations save money when they are proactive rather than reactive in denial management. Spend time determining why payers deny claims and look for patterns that show inefficiencies or gaps in your best practices. Then, make changes to the workflow to eliminate those risks. Regularly reviewing all of your policies is a solid part of revenue cycle optimization. It ensures that you’re meeting current demands and addressing potential common denials costing your practice money.
6. Leverage Data Analytics for Decision Making
Data is everywhere in revenue cycle management, but using it to its fullest extent is not as common. First, establish key performance indicators that relate to your specific, desired tracking. Then, monitor those KPIs over time to pinpoint opportunities for efficiency improvements. Data analytics software will identify areas of potential improvement for you. You can then use that information to make better decisions about minimizing loss and improving decisions to lower costs.
7. Enhance Patient Payment Options
Another part of minimizing financial loss is making payment for services as easy and streamlined as possible. Make it effortless for your patients to make payments by offering more payment options, such as online payments, point-of-service tap-and-go tools, and even payment plans. That makes patients happy and reduces the number of claims that go to collections. It’s also important to reflect on the information you’re providing to your patients upfront about their financial responsibility. It may be beneficial to put in place alliances with lending services to make hard-to-reach costs more within line with patient needs through financing.
8. Invest in Staff Training and Engagement
Getting revenue cycle certification and keeping your team up to date on methods is an excellent way to reduce costs and improve revenue management. Staff training helps with both compliance updates and skill training refreshers for coding. Your well-trained staff is more confident, efficient, and less likely to make mistakes during the process. That minimizes costs throughout the revenue cycle.
9. Utilize Technology and Automation
Here’s an essential tip. Automation can reduce human errors, get more done in less time, and help you analyze information sooner. The tools for it, including electronic health record systems, are already available and ready for implementation. Automation reduces manual workloads. That means more time for patients and less risk of errors. Consider the ease of implementing revenue cycle AI tools.
10. Foster Cross-Functional Collaboration
Here’s another essential tip that’s easy to benefit from no matter the type of organization: Collaborate between teams and departments over patient access systems, process errors, and efficiency opportunities. This is not a task just for your administration to navigate. Cross-functional collaboration allows your entire company to work towards a better outcome, building a stronger practice as you do.
Explore the Opportunities in Advanced Solutions
How can your organization improve its revenue cycle management? With technology like Adonis Intelligence, a streamlined platform that automates and improves your revenue cycle management, you can maximize recoverable revenue and drive team efficiency.
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