Revenue cycle management (RCM) is critical to the success and financial viability of any business. The basic idea of RCM is to identify and fix revenue loss, manage both the short term and long term operations to ensure a steady cash flow and to set benchmarks in business achievements.
Here are the seven best practices in Revenue Cycle Management that can be adopted by any healthcare organizations:
1. Strict adherence to Compliance Standards
The healthcare organizations have to adhere to the HIPAA compliance standards, where claims have to be submitted electronically using an approved format. By securing records digitally, healthcare providers can ensure security, and confidentiality of protected health information of their patients.
2. Outsourcing the services of an expert Healthcare Service Provider
Medical Billing and Coding takes up a lot of time and money, which makes healthcare industries think about alternate arrangements like hiring third-party vendors to handle high-volume transactions and maximize their operating margins. Healthcare service providers can thus streamline the coding and billing procedures and reduce the paperwork involved in the process. It will not just ensure accuracy and quicker processing but also better transparency, which the patients will also enjoy.
3. Predictable Cash Flow
According to the American Medical Association (AMA), up to 10% of claims are not paid correctly, which will add up to a substantial figure in the cash flow statements and hinder development. Hospitals incur a lot of expenses for hiring healthcare experts. So it is essential to ensure a smooth and steady cash flow to keep the health business in the pink of health. This is where outsourcing can help as it involves medical billing experts that can handle efficient Revenue Cycle Management tools to accurately record and dispatch claim settlements.
4. Correction of Inaccurate Collateral Data
Having a proper Revenue Cycle Management system in place will go a long way in handling the financial pressures in Billing, Collection, and Coding errors. There could be blaring discrepancies between back-end system records and the actual facts due to omissions or mistakes. Surveys show that over 22% of the claims submitted get rejected because of discrepancies and in most cases rejected claims have never been resubmitted. A foolproof Revenue Cycle minimizes the instances of claim rejection and will keep the health care facility financially robust. Train staff to verify insurance eligibility at check-in to reduce denials and monitor denials as they come in.
5. Sharing records across multiple Health Systems
Interoperability solutions enable healthcare experts to share the patient’s medical information across various healthcare components for better assessment and analysis. Health information exchanges are crucial to the overall healthcare landscape and are well poised to grow in the future. Interoperability will ensure faster and accurate processing of records in the event of changes in medical regulations and policies.
6. Training the healthcare employees
Getting the physicians trained about the scope and the different facets of RCM will ensure a smoother workflow and a positive work culture and an increase in the bottom line.
7. Performance analysis