To say that a hospital’s revenue cycle always has room for improvement is an understatement. Many times, they need to be completely reconstructed because the collection of billing and filed claims was too complicated and inefficient to stay competitive. Even when they are rebuilt and a hospital starts to get back on track, certain practices need to be established and followed to ensure the revenue cycle system is aligned with long-term goals.
How to Get Better Revenue Cycle Management
Invest in Healthcare IT Consulting
Because most revenue cycles and medical billing systems are handled electronically, providers will want to make sure they are getting the correct advice from experts that will benefit their customers and patients and promote growth. Healthcare IT consultants can spend time with your systems and give you detailed reports on the structure of your organization, help with any audits that will show profits and pricing, and show you where to improve efficiency. Many times, these consultants can quickly identify issues with revenue cycle performance, which gives them the ability to start researching solutions immediately.
Healthcare consultants can also take some of the weight off your staff by helping improve frontend processes. They will be able to see if your staff is spending unnecessary amounts of time on administrative tasks and other manual workflows and can advise you on how to streamline your processes more.
For example, in 2020, the American Medical Association found that hospital physicians and staff had to spend an average of two business days per week completing prior authorization forms. This means that instead of finding the right assistance with a consultant and getting frontend help, hospitals have had to invest extra time in paperwork with no solutions towards future changes.
Adopt Automated Processes
Healthcare is changing rapidly, and the best way to adapt is by adopting automated processes that will simplify workflows that were previously manual. Because a hospital has hundreds of financial records traveling in and out of the system each day, it’s easy to see how the human eye can get data wrong and how revenue leakage can start. By having automated software that’s made to identify discrepancies, reconcile mistakes, and give in-depth audits, staff workloads are significantly reduced, and hospitals can always stay compliant.
For example, automating eligibility and prior authorization processes would eliminate the need for human labor. Not only would the processes be error-free and completed much more quickly, but a hospital’s staff would also be able to redirect their focus to high-priority tasks, such as chargemaster code management and patient collections. This automation would also allow hospitals to save money per transaction, as it costs more for manual prior authorizations than it does for electronic ones! Just by saving a few dollars at a time, a hospital can use that money to further invest in other streamlining technology or put it back into depleted resources within the hospital.
Educate Your Staff
Whether they know it or not, each person within your hospital has a major role in how the revenue cycle is managed. They may not realize that mistakes such as errors on claims forms and inaccurate chargemaster coding can cost your organization tens of thousands of dollars each year – and that this money can be hard to get back. Each person within your staff pool needs to understand early on how their daily tasks affect the next phases of the revenue cycle process.
To achieve this understanding, you must continually educate and train staff on all revenue cycle management practices. This is especially crucial as technology can’t work properly without having humans input specific directions. Constantly communicating and coaching your staff will cut down entry errors and billing issues as they will always be updated on the latest workflow or system changes. The best part about this is that as you continue to get new advanced systems, some vendors will also provide application training, which means your staff will be able to work alongside the expert and have all their questions answered.
Don’t Wait to Fix Your Revenue Cycle
If not fixed immediately, revenue cycle mismanagement can affect your hospital’s overall price transparency and integrity. It also can cause major profit losses over time that may not be caught until someone notices that there are thousands of dollars in claims that continually go missing. By not fixing these gaps, inefficiency is encouraged. Staff won’t know what the major issues are and can’t adopt new best practices if there aren’t proactive strategies put into place first. Making just a few changes to your revenue cycle can give you back time, organization, and the ability to always ensure that patients and customers come first.