4 Ways to Improve Revenue Cycle Management in 2022

The Best Steps to Fix Your Revenue Cycle Management

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

Why is Revenue Cycle Management Important?

Healthcare organizations need to balance providing exceptional care to their communities while maintaining fiscal stability. In recent years, the COVID-19 pandemic has stretched our healthcare system thin and illustrated the need for better revenue cycle management.

Your RCM and patient experience go together, but many healthcare organizations aren’t able to increase their patient satisfaction because they can’t optimize their revenue cycle management. Because revenue teams have so much access to patients from the moment they walk through a hospital’s doors, it’s important for organizations to get their RCM systems correct the first time.

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


Four Ways to Optimize Your Revenue Cycle Management

  1. 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 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.

Healthcare consultants can also take some of the weight off your staff by helping improve front-end 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.

Healthcare IT consulting focuses on several areas in the RCM process. In charge capture, they look for errors in recording clinical data and where time is spent. Within the chargemaster, they look for coding errors, pricing updates, documentation, and cross system communication. For billing, they will look for 835/837 discrepancies and perform workflow analysis. In contract management, they will look into deductible amounts, insurance rates, late payment penalties, and compensation amounts. Finally, they will look at payments for record keeping and EMR/EHR management.

  1. 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.

Automated processes are created to be long-lasting, precise, and strategic. Any new software you implement into your hospital will be able to quickly discover discrepancies and provide solutions long before your staff even starts to notice any errors. It will also make any updates and changes very easy for you and your staff to follow, so no one falls behind!

Automation can find in minutes what takes hours for manual process to capture.

  1. 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.

The main thing patients want is clarity when it comes to their services, so your staff needs to know what they’re talking about, how to get the right information, and how to convey in a way that shows patients that they’re your priority. While training, you will need to be honest about your staff’s gaps so they understand how they’re really affecting patients – and may not even realize it!

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

Educating your staff around the requirements of the revenue management cycle is a necessary step to improve your RCM. Clinicians need to know what's billable and what's not plus how to properly document clinical activities. The billing staff need to know how to communicate charges on bills and the importance of timely bill processing. The revenue integrity team needs to know how to communicate cross-department, how to identify gaps in knowledge, and when to use a third-party audit.

  1. Outsource to a Third-Party Vendor

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.

When you find the right vendor, they’ll be able to help you with many aspects of your RCM including coding optimization, denial management, claims reviews, ensuring software efficiency, and much more. They’ll be able to keep you updated on the business side of your organization while you and your staff work to provide quality care.

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

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

Third party vendors help with standardizing codes, checks contracts with payers, government compliance, help catch over and under charging, physician-based errors and discrepancies, and audit new system implementations.

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 management can give you back time, organization, and the ability to always ensure that patients and customers come first.