Most physicians neglect to collect account receivables promptly, which is one of the most important aspects of their practice. Because of their extensive job responsibilities, they are distracted and do not pay attention to the most critical aspect of their practice. By enhancing workflow efficiency and adding stability to your healthcare financial system, revenue cycle management improves your healthcare financial system. Due to the significant increase in disease occurrences, spontaneous cash flow is often overlooked. By utilizing the expertise of our experienced cash flow managers and medical billers, we quickly resolve your issues by improving your revenue cycle.
The Best Practices For Revenue Management
From provider credentialing to monthly reporting, revenue cycle management (RCM) encompasses everything that is involved in the revenue cycle. As a result, it optimizes workflow for increased reimbursements, which is imperative for all medical providers. With RCM outsourcing, your practice can streamline its claims submissions, follow up on accounts receivable continuously, and improve quality assurance. Through our standard revenue collection process, you can minimize claim errors and denials. Global MarketInsights estimates healthcare revenue cycle market value will exceed $275 billion in 2028.
For healthcare providers, revenue cycle management is of utmost importance.In order to maintain profitability and operational efficiency, an organization should practice best practices in revenue cycle management. Financial stability is achieved when revenue cycles are consistent. The revenue cycle for healthcare providers is difficult to improve. Investigate ways to improve revenue management in the healthcare industry.
1- Establish A Clear Billing And Coding Process
For compliance purposes, you should ensure that your billing and coding processes adhere to industry standards and are well-defined.
2- Investing In Staffing
Every aspect of medical service provision requires the involvement of the right team, from collecting payments from patients to managing revenue. Your revenue cycle management may suffer if your staff does not have the proper training in the use of revenue cycle management tools and methodologies.
The benefits of investing in your employees include:
Guidance and training at the appropriate level
Education of staff on how to communicate with payers and patients.
Data entry or billing training
In addition to hiring, collaboration is also an important factor.
In order to ensure a consistent connection between departments and roles, it is imperative that a consistent communication is implemented. One person may be responsible for billing and coding while another may be responsible for denials. Connecting these two individuals will expedite the reduction of denials.
3- Regularly Update Processes
Maintaining a record of your internal processes is essential to improving your revenue cycle. Long-term neglect of revenue issues can lead to more complex problems. In the event that you have a high denial rate, you should update your processes as soon as possible.
The possibility of claims being denied is inevitable. Data from the CMS indicate that approximately 18% of claims are initially denied. The root causes of denials can be clarified and prevented through regular audits of denials.
Analyze your revenue management processes by using data analytics. Analyzing financial data can assist in monitoring payment delays, reviewing performance indicators, and determining the number of payment denials. Based on this data, you will be able to identify areas for focus and implement changes to maintain revenue cycles.
4- Offer Patients Multiple Ways To Pay
Patients who are able to pay their bills conveniently will be able to make payments more efficiently. Several payment options should be available for customers to choose from. Patient experience and revenue management will improve.
Over half of patients prefer contactless payment methods, online bill payments, and mobile wallets for paying their bills in 2021. The results of a survey conducted in 2021 revealed that nearly half of respondents found it difficult to pay medical bills.
5- Coding And Billing Of High Quality
The first step towards preventing unwarranted denials is to ensure that billing and coding are of the highest quality. Keeping up with the latest changes requires continuous retraining and refreshment for in-house billing and coding personnel. If your in-house medical coders are not providing satisfactory results, you may wish to consider outsourcing medical claims billing to a company.
Approximately 11% of outsourced medical claims are expected to increase annually in the coming years. Many providers find it more efficient to outsource their medical billing.
6- Use Ar To Manage Denials And Follow-Ups
Establish a plan for handling claims denials as quickly as possible. 90% of revenue is lost as a result of healthcare denials. As a result of the time and costs incurred in revisiting each denied claim, each denied claim costs $31.50.To prevent undetected denials, it is important to follow up on them as part of the administrative workflow.
7- Verify Insurance Eligibility
A good revenue cycle management practice is verifying the patient insurance coverage as part of the revenue generation process. Be sure to verify the patient's insurance before treating them for the first time. A plan should be in place to follow up on preauthorizations that require updating. The majority of Medicare Advantage plans require that you obtain a prior authorization before you can enroll. In order to provide services, providers should verify that they comply with these requirements. The patient may end up with an unpaid bill if the bill is not paid.
8- Monthly Reporting
The financial data should be streamlined as much as possible. Billing and denial management are not the only components of revenue cycle management. Additionally, a streamlined report should include a detailed analysis of other aspects of your business's economic situation. A number of factors are considered, including operating costs, physician billable hours, etc. By analyzing financial data in depth, practices can identify loopholes and detect trends such as revenue growth or decline.
9- Credentialing Of Physicians
Physicians who are not properly credentialed may have difficulty collecting payments from payers. Approximately 54 percent of practices reported an increase in denials caused by a lack of provider credentials in 2021. Credential changes among providers are frequent and complex.