Major Ways to Optimize Healthcare Revenue Cycle Management

There are many ways to optimize healthcare revenue cycle management. Let's have a look at the top 4 strategies to improve revenue cycle management optimization.

Healthcare Revenue Cycle Management

Top Ways to Optimize Healthcare Revenue Cycle Management

The changing healthcare landscape makes revenue cycle management rather illusive, as new laws and reforms have forced the sector to change and left many hospitals trying to maintain their revenue in a value-based care reimbursement model.

Technology platforms today can help providers, payers, and consumers interact and communicate more effectively, which will result in a plan for revenue cycle management that is more enduring. For a medical facility to maximize reimbursement, revenue cycle managers should concentrate on a few important areas. According to Anesthesia Billing Consultants, there are many ways to optimize healthcare revenue cycle management and the same are discussed below.

Healthcare Revenue Cycle Management
Infographic credit- Chetu: Revenue Cycle Management

Top 4 Ways to Optimize Healthcare Revenue Cycle Management

1. Put the patient at the center of the process

RCM-optimized healthcare facilities understand the need for improved patient relationship management. The practice gains a patient's loyalty if the team takes aggressive steps to raise patient satisfaction and foster a good rapport. The patient should be given written and verbal explanations by the staff about their financial obligations, available payment methods, and what to anticipate from their appointment. The more interactions patients have with staff about the medical billing process, which many patients find complex, daunting, and irritating, the more likely it is that they will pay the provider back.

2. Invest in technology

It could appear as though Medicare and Medicaid will always reject any claim you file. If you haven't invested in technology to keep you abreast of payer needs and diagnostic code changes, this could not be too far from reality. When you do receive reimbursement, you might discover that it's for less than you originally requested.

Investigating underpaid claims, fixing errors, and resubmitting them all take time. If your practice is subject to a TPE from Medicare, the expense is significantly higher. Prior authorizations, eligibility, medical coding, and billing can all be streamlined using automated software solutions, which can also let you know if any mistakes need to be fixed before claims are submitted. Modern technology with automation expedites reimbursements while reducing the amount of time personnel spend handling outstanding claims.

The front office should do its part to reduce denied claims, but everyone on staff needs to know what is necessary for a claim to be granted.

3. Automate prior authorizations and eligibility

The first step in effective RCM is to confirm insurance coverage at patient registration.

Insurance firms are increasingly establishing more stringent prerequisites for coverage eligibility and prior authorization. Increased requirements inevitably slow reimbursement and increase the likelihood of claim denials. Prior authorizations and eligibility can be automated to improve clinical workflow, hasten the revenue cycle, and cut down on front office staff's time spent on this activity.

4. Quickly submitting claims

Many healthcare businesses skip filing deadlines and don't submit claims promptly. Medicare permits one year from the date of the service for the filing of claims, although many private insurance companies only permit 90 days. Claims go unpaid if deadlines are missed, and the practice is forced to write off clinical services. To ensure that these deadlines are reached, systems must be in place.

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