These are proven strategies that hospitals and other healthcare providers can adopt to optimize their Revenue Cycle Management for improved client billing, claim recovery, and revenue generation.
As 2022 is turning out to be even worse for healthcare providers in terms of finances, many facilities and hospitals across the nation are taking critical steps to ensure that finances see appreciable improvement by the end of the year. The current state of hospital finance isn’t looking bright for many providers, a situation that calls for healthcare systems to take drastic steps to optimize their revenue cycle management process.
The revenue cycle management process begins from the moment a hospital or healthcare facility schedules a patient for an appointment through the time the patient’s payment or payer reimbursement is received. Revenue cycle management is how healthcare providers generate revenue. However, hospitals lose millions of dollars every year from a number of loopholes, particularly unclaimed payments.
Aside from dropping patient numbers and rising expenses, healthcare facilities are often caught in the seemingly unending web of giving free or uncompensated care to accident victims or patients with inadequate financial capacity, who never pay back. With about 87 percent of patients not being properly prepared for their medical bills, revenue cycle managers, therefore, have a hard task avoiding debt and ensuring optimal claim recovery and reimbursements.
Thankfully, by optimizing your revenue cycle, your facility has a better chance of reducing debt, optimizing your reimbursement, and can continue to provide quality healthcare services to your patients. Optimizing your revenue cycle management requires a combination of some tools (mostly powered by technology) and services that helps your facility to perfect its claim processes.
With a specific focus on reducing patient debt, here are 6 ways hospitals can optimize their revenue cycle management this year.
Many hospitals today are badly affected by claim denial. For hospitals looking to optimize their revenue cycle management, claim denials are one of the leading revenue cycle management challenges they must overcome. When patients do not have transparent information about their eligibility for certain medical procedures, it can lead to confusion about what they will owe.
To tackle misinformation and ensure parents are not surprised when they get their bills, you can have them pre-register online or via their mobile devices, before they are attended to. This can help reduce claim denials. Patient pre-registration is vital because it allows the hospitals to collect critical information before care is given. This way, you can better ensure that patients' information is always accurate and verified before they visit, as well as drastically reduce the chances that they will be surprised by a medical expense that they are neither prepared for nor able to pay.
Other advantages of patient pre-registration are that it allows healthcare facilities to cut down the administrative tasks associated with patient check-in and it helps to improve collections after medical procedures. The use of online platforms to facilitate the pre-registration phase also streamlines collection efforts, removing cumbersome paperwork from the registration process, and making your patients' experience even more pleasurable.
To reduce the delays associated with collection and reimbursement, hospitals can implement automatic payment posting. Payment delays are one of the factors that slow down revenue cycles. So by automating collections, your hospital management can save time and money that typically go into paper billing and other manual processes. For example, the patients’ saved payment method during pre-registration can be used to recoup unpaid balances.
Automatic collection tools make for real-time payment posting and streamline the hospital reconciliation process. It also reduces the risk and impact of bad debt, improves the patient experience, and decreases the overall costs of collection. Revenue cycle managers can explore the market to find a solution that allows them to implement automatic collection. Hospitals may also consider setting up automated payment plans that offer patients, especially those with large balances, a better solution that allows them to pay up over a specific time.
Another very effective way to optimize your revenue cycle management is verifying patient benefits and eligibility. Although this process may be time-consuming, it can help hospitals determine patients’ ability to pay their medical bills based on their previous payment responsibility. Healthcare providers can leverage this critical strategy to improve the effectiveness of their billing processes.
With the aid of technology, the verification process can be made seamless to ensure it does not impact patients’ experiences negatively, and at the same time enable providers to verify patients’ benefits and eligibility before and during visits, before they file their claim submission. Providers can either outsource this service to a firm experienced in handling benefits and eligibility verification or invest in a suitable revenue cycle management solution. Ideally, the tool will show all pending payers and provide critical information relating to effective coverage dates, deductibles, and other elements that give you a comprehensive view of patients’ benefits.
The role of data analysis in optimizing the performance of your revenue cycle can hardly be overemphasized. Investing in a data analytics tool that collects and analyzes patient data can help providers get a clearer picture of what is working and which area of their revenue cycle management needs improvement the most.
After all, one of the most important rules of effective management is accurate measurement. You can’t effectively manage your RCM if you don’t measure it. This is where reporting becomes very important. Revenue cycle analytics make your revenue cycle more visible through charts and graphs, providing you with critical information for improving your revenue cycle.
For example, a robust reporting tool highlights the specific payment channels your patients use, and this can provide you with insight into collection improvement opportunities. Also, to improve resource allocation and drive other important business decisions, you can rely on performance metrics and trends across different locations.
Third-party liability (TPL) claims account for over 5 percent of hospitals’ overall receivables (A/R). But unfortunately, hospitals continue to lose millions of dollars every year after providing medical care to thousands of person injury victims who later get reimbursed from legal actions that the hospitals are never told about.
Recovering your fair share from these can prove to be an effective strategy for maximizing your revenue recovery and stabilizing your margins towards the year's end. Successfully identifying and collecting on TPL claims requires expert knowledge on the subject, the ability to follow up and negotiate with the patients’ attorneys, adjustors, and investing in the right tech solutions.
At Discover Claims, we’ve invested in the development of proper tools that automatically search for, find, and provide additional information on legal actions filed by your patients, so when they get paid by Third-Party Liability (TPL) Insurers, your hospital does too. This allows your revenue cycle team to enjoy the benefits of having a specialized team without any additional hiring or other costs.
To learn more about automated solutions, contact us at Discover Claims and see how you can further optimize your Revenue Cycle processes and maximize revenue.
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