Optimizing Healthcare Revenue Cycle Management for Medical Businesses

In a nutshell, efficient healthcare revenue cycle management means that you are getting paid in a timely manner for the services and treatments that you’ve provided your patients. This can be challenging though, since the process begins the moment you accept a patient’s appointment and ends only when that patient’s balance comes down to zero. Here are some tips on how you can ensure that your healthcare business succeeds in this revenue cycle:

5 opportunities for improving hospital revenue cycle management
Starting Point

How well you begin the revenue management process is crucial to how fast you can get paid. This means that you should hire competent receptionists and registration personnel to get the patient’s contact details. Whoever is at the desk to answer calls or take patient data should already know the questions to ask and the kind of information to collect. Creating patient records should be fast and efficient.

Verify Eligibility Immediately

As part of the data gathering process, you should have your receptionist confirm the patients’ eligibility for Medicaid, even before he goes to your office for the appointment. Pre-visit verification will make things easier for your office, so that information is clear and laid out, and whatever data needed to be added have been recorded or corrected. Sometimes, appointments have to be rescheduled until coverage for the patient has been determined.

Analyze Roadblocks

Bobbi Brown writes in Health Care Finance News that you should be conscious enough to detect possible areas for improvement and work on them:

"Mine your data to discover roadblocks and areas with the greatest potential for improvement. Have a good analyst go behind the scenes and see what the data reveals – and then work to implement change in your organization. This process must be done in an atmosphere that is positive. I was recently helping a client with a lot of denials that were significantly affecting their revenue cycle. We analyzed their work queues and discovered that many of the queues weren’t being touched. Outstanding bills were just sitting there. I loved the response of the manager. He simply said, “How can we improve?” There was no blame or defensiveness, just an atmosphere of improvement."

Keep a Wary Eye Out

You should also consistently monitor your payer contracts to avoid incurring losses from underpayments, denials, and even suboptimal negotiations. Skimping down on payment could get your hospital or health care establishment in financial trouble quicker than you can fight it, so it’s best to stay on the lookout for missing payments.

It’s also helpful if you could hire reliable companies like DECO Recovery Management to help you review and manage your business’ revenue cycle. This way, you can focus more on helping lives and restoring patients’ health without worrying too much on the nitty-gritty of managing finances.

(Source: 5 opportunities for improving hospital revenue cycle management, Healthcare Finance News)

Pete Ash

Pete is the Vice President of Sales & Client Services at DECO Recovery Management. He covers the Mid Atlantic region and specializes in Medicaid related topics. It is DECO’s Mission to maximize reimbursement to our clients by leveraging innovative technology, processes and compassionate advocates to provide exemplary service.

Categories: Hospital Revenue Cycle Management, Info Articles

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