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How to reduce A/R days and increase revenue cycle management efficiency

It doesn’t matter how many patients walk through your doors if you’re only receiving a small percentage of payments. You can work hard and provide exceptional care, but as far as your bottom line is concerned, the most important thing to focus on is revenue cycle management efficiency.

What is the average number of A/R days it takes for you to complete a payment cycle? How strong are your claim acceptance rates?

These are just a few of the performance indicators to consider when assessing RCM efficiency. If you’re struggling to receive payments, use the following five tips to bring your A/R days up to speed with the industry average or even better!

1. Verify eligibility before each visit

It may sound simple enough to verify eligibility before rendering services, yet many billers find themselves jumping through eligibility hurdles after a patient has seen their caretaker.

This may happen because a patient’s coverage has changed from one visit to the next. It could be due to changes in their condition that affect eligibility, or that they didn’t provide all the information necessary for a biller to verify them.

It’s much better to gather all patient information and verify eligibility upfront than to scramble to make a claim post-service. If your current workflow doesn’t stress this, communicate the value of confirming benefits and acquiring appropriate prior authorizations with your front-of-house team immediately.

2. Utilize an automated, rules-based workflow

Think of all the different payers you work with and the many claims you send to them. Consider all the conditions you treat and the unique codes you have to use for each one.

Even your best billers are bound to make mistakes from time to time. They may send a claim to the wrong payer or input the wrong code on a claim to the right payer, resulting in denials and rejections.

The better way for them to work is to utilize an RCM platform with rules-based workflow capability. When you set specific rules, your billers will be notified if they’re about to make a mistake. Your new, advanced system can tell them if information is missing or incorrect. It can advise billers to make necessary corrections before they send out a claim, saving you a significant amount of time in the revenue cycle.

3. Streamline different revenue cycle management processes

It only takes one thing to go wrong for your entire revenue cycle to be affected. And between verifying eligibility, managing claims and processing payments, there are plenty of opportunities for mistakes to occur. Fortunately, you can prevent and correct mistakes by streamlining your RCM processes with a tool like ABILITY EASE® All-Payer.

Stop thinking of eligibility, claims management and payment processing as separate activities. Instead, consolidate these pieces of the revenue cycle into one simple, easy to manage workflow. Invest in one tech-savvy system to help you handle claims from start to finish, instead of having a separate system for eligibility verification, claims and payments.

This will save a significant amount of time, money and stress. It will allow billers to easily move from one step of the revenue cycle to the other. It will lower the risk of mistakes and increase claims acceptance rates.

Before you know it, your average A/R days will be much shorter. Plus, your staff will perform better, become more engaged and have higher overall satisfaction.

4. Diversify patient payment options

With the rise of patient payment responsibility comes a bigger need for providers to diversify their payment options.

Put yourself in the position of a consumer for a moment. Consider how often you swipe a credit/debit card, use a payment application or rely on automated payments to transfer funds. Most people use such tools when paying for everything from a snack at the corner store to their car payment. They expect to have similar payment options when they’re billed for medical services.

This change comes at a low cost when the long-term benefits are factored in. Although it may be a big investment upfront to start offering modern payment options, the positive response from patients will provide the ROI you’re looking for. They are more likely to pay on time and you’ll be able to process payments much easier, too.

5. Resubmit all denied claims

The final way to increase your RCM efficiency is to make sure no claim goes unpaid. The tips mentioned above should significantly reduce the amount of denied claims your team has to resubmit. But, whenever a claim is denied, it needs to be adjusted and sent back to the appropriate payer.

You may prioritize new claims over denied claims. However, every single unpaid dollar adds up it can contribute to the amount of money you have outstanding, or it can be revenue you collect and utilize.

Luckily, a streamlined workflow can make it much easier to manage denied claims. Combined with a better eligibility verification process, rules-based functions and diversified payment options, your RCM efficiency will be better than ever.

For more tools to take your RCM results to the next level, check out our full suite of revenue cycle solutions.

Inovalon® and design, Inovalon® are trademarks of Inovalon, Inc.

About the author

David Swenson, Manager, Sales Engineering