3 Tips to Transform Your Revenue Cycle Management

3 Tips to Transform Your Revenue Cycle Management

Revenue cycle management is a multi-faceted process that touches all parts of a hospital. Hospitals not prepared to take control of their revenue flow find themselves leaking millions as their bottom line falls away. These are challenging times for hospitals around the globe, but they don’t have to be. Here are three ways you can take back control of your revenue cycle.

Why is Revenue Cycle Management Important?

The past year more than ever, has made visible the thin road hospitals walk.  There is a narrow walkway they must balance as they strive to provide exceptional care to their communities today while maintaining fiscal stability so they can continue providing care to their communities tomorrow. In a typical year, that is difficult enough, but the Covid-19 crisis has stretched our healthcare system thin and illustrated the need for better revenue cycle management.

To read through a comprehensive guide to revenue cycle management, click here.

The American Hospital Association has calculated that the United States’ health organizations lost a combined $323 billion during the pandemic’s rampage in 2020, and that loss hasn’t slowed through the new year either. For hospitals trying to keep their heads above water, it’s time to get serious about revenue cycle management. The good news is that there are many different avenues for revenue cycle improvement.

Three Tips

If you’re part of a healthcare organization looking to get ahead, check out these three tips to reinvigorate your revenue cycle management.

Invest in ALL of your staff

Your systems and software are important, but the most crucial piece of your hospital are the people inside of it.

This is true of your patients, doctors and nurses, accountants, and billing experts, but it’s also true of positions we don’t usually associate with revenue expertise and skill. Let’s consider the front office. This the usually the first touchpoint for patients but is often overlooked. However, good revenue cycle management starts with collecting accurate patient records because those records become the basis for charging and billing. This means that your front office staff are a crucial piece of your revenue cycle.

From one angle, this means recruiting and training your staff to have a holistic understanding of the revenue cycle, not just their little piece of the puzzle. It also means investing time and effort to show them that they matter. That will only work if you actually believe that. A transparent revenue cycle process quite literally starts with your transparency towards your front office workers.

This makes staff training an essential part of the revenue cycle journey. Training should not be a one-time experience after they’re hired, but a regular update to ensure that every staff-member is bought in and kept up-to-date with changes in the hospital. Training about new software is bound to get a little boring if you’re not careful, so keep the trainings fun, interactive, and inspiring.

Discover Revenue Leakage ahead of the Billing Process:

Don’t wait till after the bills go out to reconcile billing discrepancies. Too many hospitals either don’t attempt accurate revenue reconciliation or do so too late in the game. Health systems today are trending towards clinically driven revenue cycle EHRs. This means that clinicians themselves are the central link in the revenue cycle chain. So much so, that revenue reconciliation accuracy is dependent on clinicians’ documentation.

It is’s vital to have a strategy to reconcile that revenue. Bills adjustments are a crucial piece of the revenue cycle journey and also an important step in healthcare claims. Develop a reconciliation strategy that:

  1. Double-checks every physician-based recording to ensure accuracy
  2. Has an easy sign-off for directors on a department-by-department basis.
  3. Integrates the clinical systems with all other systems within a hospital, especially billing and lab.
  4. Addresses mistakes BEFORE the bill is sent out.

If this seems like it may be out-of-reach for your healthcare organization, it may be time to think about outsourcing.

A modern world means modern solutions

Preparing and training staff is only one piece of the puzzle. If you want to truly take control of your RCM, you need to equip your hospital with the right technological solutions. Third-party consulting companies can:

  • Organize and standardize hospital charging and coding
  • Identify errors and discrepancies with physician-based charging
  • Catch undercharges and overcharges in billing before the bill is sent out
  • Check contracts with payors to ensure every dime is paid for
  • Guarantee compliance with State and Federal Regulations
  • Audit new systems during implementations

Modern solutions can be difficult to develop and implement on your own, so consider outsourcing to third-party IT consulting partners. These revenue cycle experts can have you performing above baseline within months or even weeks.

Check out this article to discover what to look for in an IT consulting partner.

Outsourcing revenue cycle management can help healthcare organizations take back control of the revenue process and streamline workflow processes while allowing the hospital to focus on patient care. Companies that focus on revenue cycle management will have years of experience and can leverage their capabilities in automation, data auditing, and even AI to help empower hospitals to thrive.

At Avelead, we’ve partnered with hundreds of hospitals around the country and developed industry-leading solutions that can help your hospital today. Click on the link below to schedule a demo: