Collecting revenue is one of the biggest challenges that healthcare providers face. As patients struggle to pay until their higher deductibles kick in, it can strain the relationship with their provider, as well as the healthcare system’s revenue. Then, multi-payer plans and the high volume of claim denials is further complicating reimbursements.
It’s no wonder healthcare providers are focused on improving their revenue cycle, the muscle behind how organizations collect payments and reimbursements. While the challenges aren’t going away anytime soon, the good news is there are ways to streamline the revenue cycle to help providers start to generate more revenue – and faster.
1. Manage claims electronically.When claims are submitted with incorrect information, as duplicates or to the wrong payer, it can result in a denial. Use technology to manage claims electronically, establish workflows and scrub claims for errors before they’re submitted. It’s also helpful to have all the information for a claim in one record, including denial or adjustment information, to make it easy to refer to later.
2. Swap paper checks for electronic payments.Two years ago, it took up to six hours a day for the accounts receivable team at Hannibal Regional Healthcare System to reconcile payments.
“We still received a lot of paper checks, which we processed manually,” says Heather Hipkins, Accounting Manager for the healthcare system, which includes a hospital, clinical group and home health organization. “It was time consuming and complicated by the way our payers often combined payments for all of our areas,” she explains.
Using the automation tool from CommerceHealthcare®, the team streamlined their cash reconciliation process. Today, it only takes 30 minutes.
3. Repurpose staff members’ time.When claims and payment processing are automated, staff members will find they have more time for other projects. Every revenue cycle team knows there’s always more to do. They could follow up on troubled claims, focus on customer service or look for ways to improve the revenue cycle process even more.
4. Follow-up on denied claims.According to a 2015 survey by Advisory Board, 61 percent of denials are caused by errors. If staff member workloads are reduced thanks to automated processes, they can follow up and rework denials to capture that revenue.
5. Use data to find room for improvement.An electronic revenue cycle platform should also report on collections and accounts receivable success over time. Track key performance indicators to spot opportunities to improve, like areas where the organization may be losing money.
One could argue that the revenue cycle is at the heart of a strong healthcare organization. It touches all stages of a patient’s experience – from care to billing and payment – and is the muscle ensuring the healthcare provider gets paid for its services. A streamlined, efficient revenue cycle stands to help organizations better tackle the challenges the industry faces and focus on improving the health of patients in their communities.
- 5 ways to maximize your AP strategy and increase revenue.
- Getting the US healthcare system to a healthier state - through banking.