7 revenue cycle management best practices
We understand that your focus is (and should be) caring for your patients. But we also understand that patient care cannot happen without processes in place to ensure proper payment of expenses. With ever-changing healthcare regulations and new reimbursement models, it’s imperative for healthcare organizations to maintain a strong, stable revenue cycle management(RCM) process.
Here are seven best practices to help you develop and implement a successful RCM program.
1. Collect more information up front
Because the patient is such an increasingly important payer in today’s healthcare system, it’s crucial to collect all personal information available at the time a patient first seeks care potentially even before they arrive for an appointment. Not only does this information provide the foundation for the claims you will process, but it will also dictate how you will collect payments from the patient or make payment arrangements for the balance due. Effective communication helps patients to understand their benefits and possible treatment alternatives.
2. Aggregate patient data
As benefits and insurance regulations continue to change, it’s important to implement a revenue cycle management process that is able to aggregate all of the data throughout the cycle. It will provide benchmarks and analytics for key insights that can improve your process and your business success. Sometimes there is little you can do to increase your income and you may need to look at the expense side of the business. Easy-to-read financial reports can help management and staff to better understand expenses, ways to reduce costs and maximize revenue where possible.
3. Consolidate revenue cycle management to a single provider
Some healthcare organizations use multiple vendors for different revenue cycle functions, requiring extra time and resources to manage it all. Instead, consider consolidating your revenue cycle management operations to a single provider who can provide eligibility verification, claims management and patient payment processing. A single, comprehensive system streamlines workflows, increases staff efficiency and simplifies the billing process for patients, which can help them better understand and meet their obligations.
4. Collect patient payments at or before the point of service
This is one of the most difficult parts of revenue cycle management, but also one of the most critical. Collecting patient payments as much as you can, as soon as you can is important in keeping your organization’s money flowing. Determining Medicaid and Medicare eligibility and helping patients understand their coverage options is key. This is made easier by developing a relationship with patients and educating them on the insurance process, so they understand their financial responsibility ahead of time. As medical deductibles increase, more patients are having to pay more and may need to arrange financing or payment options prior to receiving non-emergency services.
5. Track claims throughout their lifecycle
Identifying the reasons for claims denials is as important as resolving them. Verifying insurance eligibility is the first step to ensure accurate billing. It’s also important to be able to track claims from submission to payment. Claims denials from Medicare and other payers should be recorded and analyzed to look for trends or common errors that can be corrected to stop the cycle of lost revenue.
6. Implement staff development programs
One of the best ways to reduce denied claims is to ensure they are coded and processed correctly. As healthcare changes so quickly, it’s important for providers to develop and implement regular education programs for employees that teach proper coding techniques, comprehensive chart documentation and financial policy reminders. Besides reducing medical errors, training can also help reduce employee turnover.
7. Keep improving performance
Even if your revenue cycle is functioning nicely, avoid the maintenance-mode mentality. Instead, keep pushing for optimum performance that maximizes your cash flow and net revenue. Use your data to find ways to earn a little more and to save a little more perhaps by cutting costs, decreasing denials and reducing bad debt and underpayments.
Contact your revenue cycle management experts today
When you need assistance implementing best practices for your revenue cycle management process, reach out to our experts at Inovalon. We have powerful applications to develop and maintain positive revenue cycles within your physician practice, hospital or other healthcare organization no matter the size. Request your free quote today and start maximizing your revenue.
