The evolution in the healthcare industry has created opportunities for the use of technologies like revenue cycle management. It has become a cornerstone for efficiency in the healthcare industry today.
Revenue cycle management is one of the most important processes that keeps small practices running and helps them maintain healthy operating margins. It has also eliminated the traditional processes that are often filled with human errors, leading to multiple claim denials or rejections.
In this blog, Unify Medicraft explains the meaning of revenue cycle management and some important steps on how to improve revenue cycle management. Continue reading for more detailed information.
What is Revenue Cycle Management?
Revenue cycle management is a financial process that healthcare providers use to manage their revenue through patient care. RCM starts with patient registration and ends when the patient’s payment is claimed by healthcare providers from the insurance company.
When you keep your revenue cycle consistent, it stabilizes your finances and ensures streamlined functionality in your practices. Revenue cycle management is also important for ensuring all the administrative processes are done promptly without errors.
How to Improve Revenue Cycle Management
Improve Appointment Scheduling
The first step to take if you want to improve revenue cycle management is to make sure you have as many patients as possible coming for treatment in your hospital. This can be done by making it easier for patients to schedule their appointments from the comfort of their homes.
Sending out reminders to patients that schedule an appointment can also reduce the number of no-shows and plays a huge part in improving the revenue of healthcare providers. Additionally, using software that includes automated reminders such as text or SMS messages will remind patients to show up on time for their appointments.
Patient Registration
Registration is one of the most important processes before providing medical services for any patient. Accurate information about patients must be registered including their names, date of birth, services they want, insurance identification number, and many more. Also, verification and updates of existing information of returning patients should take place before their appointment. Incorrect or error of any type during patient registration can cause claim denial, affecting your revenue cycle management.
Patient Insurance Verification
According to statistics, failure to verify insurance coverage is one of the leading causes of claim denials and loss of revenue for healthcare providers.
Patient insurance eligibility is an important task to carry out if you want to reduce claims rejections and remove a common recurring problem from your medical billing process. During this process, your administrative staff contacts the patient’s insurance company to verify their insurance policy, coverage for the patient, and patient responsibility.
Medical Billing and Coding
Your medical billing and coding teams should ensure that all the required information and codes are accurately documented in the patient chart during medical billing. They should also ensure that all the Current Procedural Terminology codes are accurate with the correct diagnosis and correct any errors before sending claims to the insurance company.
Carry Out Claims Scrubbing
Claim scrubbing is the process of ensuring accuracy, correctness, and compliance of medical claims before submitting claims to the insurance company to reduce the number of claims that are denied or rejected. Although the procedure can be lengthy when using a traditional method, it is an easy way to improve the chances of being paid promptly.
There are many medical billing software that make the process of scrubbing nearly instantaneous. Therefore, healthcare providers do not have any excuse to ever submit a claim that hasn’t been thoroughly verified.
Outsource Medical Billing
We all can agree that one of the easiest ways to improve your medical billing process is by partnering with medical billing services. Working with an expert removes the burden of running an in-house team from your list of responsibilities. Their duty is to improve your billing process efficiently and get you paid faster. They are a great option if you are struggling to improve revenue cycle management as a healthcare provider.
Invest in Staffing
When you have the right administrative team as a healthcare provider, you remove the headache of having many issues with your billing process, patient registration and ensuring revenue is properly managed. Even if you have all the right tools in place, everything will be a waste without training your staff on how to use the tools tremendously.
Some of the ways to invest in your staff include the following :
- Providing the right training for the administrative staff
- Continuous education on communicating with insurance companies and patients
- Providing training on how to use the billing technology or data entry
- Collaboration in the workforce of your organization
- Consistent connection between different roles and departments
Streamline Prior Authorization
Insurance companies require healthcare providers to get their approval before conducting certain procedures, medications, or medical equipment for their patients. Not all medical services require prior authorization, but it is mandatory for planned surgeries, mental health services, and many chiropractic and pain management services. Failure to abide by the rules of the insurance company may lead to claim denial which will ultimately affect their revenue cycle.
Manage Claim Denials
Denied claims are nearly inevitable in medical billing, but they can be minimized by allowing experts to help with your billing process and medical coding. For example, outsourcing your revenue cycle management or using the right medical billing software will ensure your billing is not denied.
According to statistics, many denied claims are lost and are never resubmitted, leading to lost revenue for healthcare providers. Therefore, it is important to always follow up on every of your denied claims.
Also, having billing software that automatically indicates denied claims for review and resubmission serves as a reminder and ensures healthcare providers get paid for the service they provide to their patients.
Follow Up on Patient
You will be surprised to know that there are patients who do not pay their medical bills on time after insurance coverage. Asking your staff to reach out to those who are delinquent regarding their medical payments will remind and encourage them to complete their payments. Also, providing these patients with payment options such as monthly, quarterly, or weekly deposits will give them the flexibility they need while maximizing your revenue.
Multiple Payment Option
While it is great to focus on seamless claim submission to insurance companies, patient co-pays with coverage can still make up a significant amount of reimbursement potential and a great way to improve this is to give your patients multiple payment options.
According to statistics, many patients preferred using contactless payment methods, online bill pay, and mobile wallets to pay for their medical bills. Many patients also said paying their medical bills was harder than paying anything else. All this shows patients will be effective and consistent with their payment when patient have convenient options.
Streamline Monthly Reporting
A healthcare provider must ensure all their data reports are streamlined across all departments of their practice. Revenue cycle management is not only about ensuring smooth billing and avoiding denials, but also the ability to have in-depth overviews of other financial elements of the business. These include operational costs, billable physician hours, and many more.
Regularly conducting in-depth reporting allows healthcare providers to analyze all their financial data collectively, correct errors, and spot what is improving their revenue.
Use Software for Administrative Work
Software is a great way to streamline workflow and reduce the burden on your administrative staff. When software is available for patient registration, appointment scheduling and other processes, it avoids human error, and your staff also spends less time on each patient. It also improved productivity and staff satisfaction.
Update Processes Regularly
Healthcare providers must stay up to date with industrial regulations and other ever-evolving rules in the healthcare industry to grow their revenue. For example, if you are having a higher claim denial, updating your billing code immediately is crucial as some of the codes might have been replaced. Also, doing regular audits on denials helps find out the root causes so they can be avoided.
Focus on Patient Satisfaction
Patient satisfaction plays a crucial role in revenue cycle management as satisfied patients are more likely to pay their bills on time and come back for more medical services. The best way to ensure your patient is satisfied is by providing high-quality care, clear communication, and efficient billing processes.
Additionally, handling patient medical issues promptly and offering personalized assistance can further improve their level of satisfaction. It also helps build positive relationships and improve revenue.
In Conclusion
The steps above are in the right direction if you are looking for how to improve revenue cycle management as a healthcare provider. Also, having an effective and well-streamlined RCM process contributes to the financial health of your business.
Unify Medicraft is a software designed to help healthcare providers deal with the growing challenges they face with navigating the delicate balance of providing patient care and improving their revenue. With our software, they are able to have seamless medical billing and improve revenue cycle management.