Revenue cycle management (RCM) must evolve for health care organizations to not only remain solvent, but to thrive in the current environment. The best path to managing the evolution, or more precisely, where to start the journey, depends on which industry expert you believe. However, there is a common thread whether you are listening to a marketing expert, a customer service coach or a financial advisor – process optimization is business-critical.
Billing and coding specialists maintain managing revenue stream health and vitality begins and ends with coding and regulatory compliance. Marketing professionals insist enhanced consumer engagement is the most significant driver for improving cash flow effectively. Financial counselors claim controlling operating costs and uncollectible accounts receivable is the most significant challenge facing health care providers today. Who is right?
Every Touch-Point is Critical
The truth is, all of the experts are right. Organizations that only focus on one problem often find that improvements in one area trigger challenges in another area. Asking patients to fill in and print an online pre-registration form seems like a good way to streamline the check-in process.
What happens if patient devices aren’t compatible or the patient doesn’t have Internet access? Failing to train front-desk staff how to handle situations where patients forget the paperwork or fail to print all pages, can be less efficient, and more-time consuming, than requesting new patients complete forms during the first visit.
A good revenue cycle management company understands the revenue cycle triad, people, technology and processes.
Managing the Triad
Effective healthcare RCM examines claims filing processes, reimbursement patterns and revenue generation; however, it is not as simple as following the money trail. Updating technology to protect personal data, implementing efficient processes to determine patient eligibility and collect co-pays, and proper coding are essential in every health care delivery setting.
Integrating technology that enables patient/provider communication and seamlessly connects accounting and EHR systems improves transparency and typically shortens collection cycles. In addition to upgrading technology, educating patient-consumers and training staff how to use technology enhances productivity and patient engagement, and positively impacts the bottom line.
Partnering with a Revenue Cycle Management Company
With the cost of operating a health care organization increasing, every administrator must examine the entire revenue cycle stream, starting with the first contact point and continuing throughout the provider-patient relationship. Finding a revenue cycle management company to help you navigate the journey could be the most beneficial starting point.
A very good RCM company:
- Leverages human capital fully. Whether it is training scheduling staff to discuss co-pay responsibilities during the appointment setting process, or decreasing denials by providing advanced ICD-10 training to coding staff, giving personnel the tools and knowledge base to perform tasks efficiently is essential.
- Understands the importance of effective communication. Utilizing multiple communication channels, email, printed letters, telephone calls, and online portals, improves transparency and enables more productive internal communication. Refining lab report processing could speed up hospital discharge times and increase patient engagement, both factors that impact revenue.
- Strictly adheres to industry standards and compliance guidelines. Third-party payers have rigorous claim filing guidelines. Reputable RCM partners stay abreast of government regulations and third-party payer timelines and coding protocol, and they help healthcare organizations customized their unique processes to achieve full compliance that expedites faster reimbursements.
- Invests heavily in professional development. It is not enough to help hospitals and clinics streamline their internal processes and training programs. A very good revenue cycle management company invests in ongoing training programs and technology to make sure they are providing the most accurate, relevant and beneficial resources to their clients.
