Tips to Ensure a Healthier Revenue Cycle

 

A company’s profitability depends on revenue and tends to follow the revenue cycle. Profitability increases with a smoother process. Healthcare organizations are working on the same formula. That’s why revenue cycle management plays a key role. An effective revenue cycle ensures that all invoices are clear according to the payor’s requirements and that all provided services are paid. Hence, RCM solutions should understand the leakage points to ensure smoother revenue cycles. The leakage points may be referrals, registration, coding, and billing errors. Moreover, unverified insurance, unpaid claims, and denial requests are also obstacles in the revenue cycle. Here are several tips to ensure a healthier revenue cycle.   

Revenue Cycle Automation 

In today’s world, healthcare and technology are intertwined. Medical practices use various technologies like EHR software, and PM software to automate most clinical tasks and improve patient care.   

According to the HIMSS Analytics survey, 31 percent of practices still rely on manual paperwork for revenue cycle workflow. Manual work is time-consuming, can lead to errors, and burdens administration staff significantly.   

Get rid of these hassles, and it is time to automate revenue cycle workflow wisely. It is found that practice can save 8.5 billion per annum by automating the revenue cycle.   

So, healthcare organizations should integrate the best technologies that help them to minimize burden and achieve maximum efficiency. Utilize the best RCM software to avoid the lack of integration between legacy systems and EHR, which hinders revenue reimbursement.   

Frontend Improvement 

Experts in the healthcare industry estimate that almost 90 percent of claims denials are preventable. Providers need to focus on frontend improvement to avoid backend issues. For instance, the most common reasons for claims denials are missing or inaccurate demographic information. This problem can be solved by automating the workflow.   

The frontend workflow improvement can be achieved by automating prior authorizations. PA is beneficial for verifications, patient registration, and other frontend workflow that increases revenue cycle efficiency. With tools and technologies, clinician prevents care delays, claims denials, and other backend errors.   

Bringing patient collection and patient financial experience to the digital era is critical for a healthier revenue cycle.   

File Claims on Time  

Most healthcare organizations must file their claims on time and meet their filing deadlines. Medicare allows one year to file the claims from the date of service, but private insurance only has 90 days limits for it. Claims must be filed on time to avoid it being unpaid, and ultimately practices face loss. To prevent this inconvenience claims filing process must be on time.   

Denial Management  

If the tips mentioned above are unfollowed, it may result in denial claims. Identifying trends and root causes of disavowals is essential for any healthcare organization. A standardized process should be implemented for the entire staff to minimize the risk of denial claims.   

Summary:  

Technologies like RCM solutions and EHR software play a key role in a healthier revenue cycle. Automation with technologies reduces human error and makes all processes smooth and fast, minimizing claims denials. It ultimately contributes to a more beneficial revenue cycle.