How Hospitals Can Improve Revenue Cycle Management

It's important to consider how hospitals can improve revenue cycle management and what kind of impact it can make on your business. Here's what to know

January 14, 2019
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According to researchers at the University of North Carolina, the trend for smaller, rural hospitals closing will continue to increase. Hospitals and medical practices spend a lot of time seeking the best outcomes for their patients, but sometimes they’re not looking as closely at their own financial health. Here are five areas to examine for hospitals hoping to improve their revenue cycle management.

Think Holistically

Just as physicians look at the whole patient, hospitals need to view managing revenue as a continuous process that begins with the first patient contact and ends with the final payment for services. Along with that continuum, there must be collaboration among people who handle getting initial patient information all the way to the personnel responsible for collecting full payment for services on the back-end.

Use Key Performance Indicators

Using key performance indicators helps organization monitor trends, so that adjustments can be made anywhere along the revenue cycle before a trend becomes an irreversible disaster. Experts recommend monitoring five KPIs: net days in accounts receivable, cash collection compared to net revenue from patient services, collection costs, claim denial rates, and final claim denial write-off expenses as part of net revenue from patient services. Using KPIs also means that someone knowledgeable about the entire revenue cycle needs to monitor those indicators in real time.

Collect Patient Portions Upfront

Patients who don’t pay or are slow to pay can affect the efficiency of revenue cycle management. Experts suggest collecting as much of the patient’s responsibility for the bill upfront as possible. Two ways to improve this outcome are by providing estimates of total cost and utilizing credit card on-file services. Statistics show that when patients have a better idea of what their treatment will cost, there is more follow through in paying for services.

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Automate Prior Authorizations

The increase in insurance providers’ demands for prior authorization before treatment can significantly slow down the revenue cycle, mainly if authorizations are being handled manually. Just automating the process keeps revenue moving through the process without putting additional pressure on case management.

Thorough Clinical Documentation

Treatments, diagnoses, and services provided need to be carefully recorded at the time they occur so that mistakes don’t happen during coding. The more thoroughly this happens, the more clearly it can be spelled out on bills and help reduce claim denials and/or patients refusing to pay.

In the past, many facilities had little connection between the front and back end of the revenue cycle and the clinical care portions where treatment decisions and case notes were recorded. Experts say familiarizing everyone along that revenue cycle with how each phase interacts with the other can increase the profitability of a hospital or medical practice, as well as efficiency

Final Thoughts

According to Medicalubs, for organizations looking to streamline revenue cycle management, even more, there are options out there that can take some of the burdens off your in-house staff. It might be worth considering software solutions or utilizing a medical billing company. No matter which option you choose, know that there are plenty of ways to approach your revenue cycle management and in turn improve your hospital. The sky’s the limit.