Enhancing Revenue Cycle Management in Healthcare Industry

As the medical industry is gradually stirring from service-based care to value-based care, hospitals and healthcare operations management consultancies are challenged with improving patient care while minimizing costs. Hence they are finding it hard to maintain a steady stream of revenue. The drop in cash flows and margins are another reason to significantly improve and maintain a healthy Medical Revenue Cycle Management. Effectively managing them can make healthcare practice more responsive and efficient in terms of growth and operational changes.

A robust hospital revenue cycle is significant to allow healthcare systems to thrive. RCM healthcare solutions are capable of boosting performance by integrating every single step of the care cycle; starting with the very first patient touch point to the ending of the payment for medical services. However, there is a dramatic change in the way patients choose their providers and pay their bills. Hospitals can tackle the financial impact caused by a modification in the delivery system by upgrading their RCM capabilities.

There are some specific ways to manage and enhance the medical revenue cycle management:

• Analyzing the data and understanding the results to discover the trends that didn’t work well and find out their cause. For a full picture of the healthcare revenue management, the billing data of both the hospital and physician is considered
• Benchmarking your healthcare data to identify areas in the hospital revenue cycle where improvement is needed. It is ideal to combine data from disparate IT systems and optimize it for analysis.
• Comparing RCM healthcare services with other healthcare systems, especially against industry standard revenue cycle excellence.
• Outlining the differences in terms of technology, process and other metrics that are key performance indicators on the revenue cycle.
• An enterprise data warehouse can be used to mine healthcare data. This particular solution can help discover the roadblocks, automate manual work and implement a positive change in RCM healthcare services.
• Working in partnership with membership societies, professional organizations and frontline staff as it helps gain a lot of insights. Also asking for guidance on best practices for healthcare revenue management as well as healthcare operations management such as collection practices and medical billing services.
• Since margins get tighter, it is important to monitor all contracts and communicate clearly with payers. Hence contacting them frequently and dismissing payers who are denying claims, or putting unreasonable demands is vital.
• It is also important to maintain convenient touch points with patients to enhance care. One example is having a well-designed patient portal. This gives patients the opportunity to pay bills online, thereby increasing their satisfaction levels
• Consider back end revenue cycle management activities as against a dynamic upfront patient experience. This can positively impact patient satisfaction.
• Using key stakeholders and clinical representatives as part of the revenue cycle management committee to make the right decisions that are data-driven.
• Consulting with healthcare revenue management vendors for successful tips, advice, and expertise in this domain can help gain real-time knowledge.
• Designing and implementing a hospital revenue cycle scorecard that regularly tracks performance can generate actionable insights.
• Apart from monitoring performance, integrating advanced analytics and big data can show the direction of trending factors in RCM healthcare services.

These measures can help create a full revenue cycle strategy that elevates and transforms financial health. The front-end revenue cycle can be used to leverage the patient access department as one can leverage the patient payments journey. The accuracy of RCM healthcare services can be improved by integrating clinical and financial systems in the middle-revenue cycle. This leads to a drive in sustainable growth and an increase in overall revenue using the back-end revenue cycle by refining the medical billing, healthcare operations management and other systems. 

Using these steps can transform any hospital revenue cycle system into a sustainable and high-performing financial engine to increase results and accountability.

Maple Software is capable of handling every aspect of medical revenue cycle management for large and small practices alike. It provides the right products, services, and expertise to manage your medical billing services in an efficient manner thereby allowing you to focus on a patient’s well-being. Our team consists of professionals who are CPC/AHIMA certified and AAPC certified coders who efficiently manage your account receivables and identify reimbursement opportunities which can deliver an immediate return.