The healthcare industry is large and there needs to be a proper revenue cycle to function properly. Without a proper and functioning revenue cycle, hospitals will not be able to fulfil their promise to provide superior healthcare services to their patients. Revenue tracking from the first patient appointment to the very end of the reimbursement process is managed by revenue cycle management services.
The start of the revenue cycle can be marked when a patient schedules an appointment with their doctor. After the patient receives all services, the hospital receives reimbursement for the medical services it provided to its patient. This means the end of the revenue cycle.
Effective Steps to Review Revenue Cycle Process
When evaluating your revenue cycle, you should also take the time to review the process itself. There are many moving parts to your revenue cycle, from initial registration to subsequent underwriting. Looking at the process step by step allows you to analyse the workflow and time required to complete each step of the process. Which can shack light on areas that need improvement.
Key Performance Indicators:
To fully understand your revenue cycle, you need to have a good understanding of your practice’s KPIs. Once you’ve determined them, compare them to industry best practices. Performance metrics to consider include net collection rate, days on account, and more. This type of analysis will permit your practice to identify opportunities for improvement.
Benchmark Against Peers and Competitors:
By understanding the current state of your revenue cycle process, you can benchmark it against your competitors and industry peers. This allows you to identify areas where your organisation is doing well. And areas where improvements could be made. For example, if your peer hospitals see an average payment of 90 days. While your organisation has an average payment of 120 days. You know your process could be improved.
Getting the right patient information in the early stages can make or break your revenue cycle management success.
Inaccurate patient data leads to delayed processes and incorrect data. Which is critical to monitoring and measuring RCM effectiveness.
It is good practice to encourage the pre-registration of patients. This allows for a more careful review of patient information and prevents claim denials.
Modernise Claims Processing:
Claims cleaning is the process of ensuring accuracy, correctness, and completeness before claims are submitted to insurers. It’s an easy way to improve your chances of getting paid instantly. And it’s another task that lends itself well to automation.
Instead of the long and laborious manual labour that cleaning used to require. Modern software has made the process almost instantaneous. There is simply no reason why your practice should ever submit a claim that has not been vetted by your internal clearinghouse.
Your plans should also assess your firm’s workforce levels. Review procedures with your team to determine the people needed for each stage of the process. And how much time will be spent affected by variables such as specialty, patient information, and technology needed? You can also use this opportunity to address any future staffing requirements. That may arise as a result of your new goals.
This has been considered one of the most important stages of any medical billing system. The process of tracking payments due requires patience and diligence.
A good revenue cycle management system will help you provide an adequate explanation of insurance coverage to your patients and support payments.
In general, denial management can involve any aspect of the revenue cycle that may result in no or low reimbursement. Reasons for denial may include incomplete or inaccurate insurance information, lack of pre-certification, or prior authorization. Failure to capture all tests or procedures, errors, or omissions in the coding of diagnoses and procedures. Filing of claims out of past limits, or denial due to lack of medical necessity. The best practice is to monitor and track rejections at the time payments are posted. Denials should be pursued by the payer, denial type, and provider.
Inquiring About Revenue Cycle Resource:
When it comes to the revenue cycle, some technologies need to be used to get the right results. It is important to identify the resources and materials used for each of the activities. Discussing with your management team the handling of the process and the resources used is also key to success.
If you want to stay on top of healthcare billing developments. You would need to hire proper revenue cycle management services. As they can look at the timely submission of claims along with looking at all the necessary solutions.
How We Can Better Your Revenue Cycle Process
A thorough evaluation of your revenue cycle can significantly reduce the number of claims denied in your practice. Leading to higher revenue and overall practice efficiency. The Right Medical Billing team specialises in revenue cycle management for medical billing and emergency room practices. And we look forward to working with you to help you succeed.
Our RCM services aim to reduce lead times, avoid replenishment costs and waiting for refunds, and maximise cash flow. In particular, the Right Medical Billing team strives to develop an expert opinion for your practice. Allowing you to get ideas on what needs to be addressed and make the required adjustments.
We are pleased to provide you with a wide range of practice management services to move your practice to the forefront of your industry.
The revenue cycle is an important and complicated process in healthcare organisations. It helps administrators manage patient check-in, billing, insurance verification, clinical documentation, and other processes necessary to maintain financial health while delivering care. It is important to understand that while the revenue cycle process is important to your organisation, it is constantly changing. As an administrator, it’s your job to keep up with these changes and ensure your organisation is always running as efficiently as possible. If you are just starting your journey as a hospital administrator or hoping to take on more responsibility in your current position. This means you are not alone. Hiring an expert team like WWS for your medical specialty makes sense. When looking for help with your management requirements revenue cycle.