Top Ten Ways to Improve Revenue Cycle

The revenue cycle can be a complex and daunting part of the healthcare system. Even with entire departments and countless hours of preparation  a claim can still be denied. Let's take a look at 10 of the top ways the revenue cycle can be improved to help ensure your healthcare organization is getting properly reimbursed.

1. Focus on Accuracy- Accuracy is vastly important when preparing claims. If one item is wrong the entire claim can be denied. It is the duty of the biller to make sure everything is accurate with the information they have, but it is the responsibility of everyone else in the organization to make sure the information they put in the system is correct as well. Patient access, coders, or even clinical workers inputting the wrong information could cause a claim to fail.
2. Submit Claims Daily- Claims should be submitted daily to help ensure a consistent cash influx. Research also shows that claims that take longer to be sent out have a higher chance of denial so its best to get them sent out as quickly and accurately as possible.
3. Incorporate the Right Technology- Using the right technology, especially the right EHR system is key to being timely and accurate. Being able to keep track of all the data needed can be negatively impacted which results in fewer claims being sent out and less revenue being taken in.
4. Train Staff Adequately- The staff members will be the one's preparing the claims and sending them out. If they are not properly trained then mistakes are inevitably going to be made. Make sure they have the right tools and vet their work before putting them off on their own. 
5. Stay Current on Billing and Coding- Billing and Coding regulations change frequently so it is important to stay as current as possible. Being proactive and knowing about future changes will prevent unsuccessful claims from being sent out your door.
6. Ask for the Patient's Help when Needed- The system is never perfect and information is going to sometimes be missed. Don't hesitate to reach out to the patient for missing information or to clarify that the information you have on file is correct.
7. Monitor Pending Issues- A portion of claims come back with soft denials, in other words they are missing information and are left pending. Staying on top of these issues is vital to successful payment because there could be a specified window of time you have to provide the information they need.
8. Monitor Payments- Just like monitoring issues you should be monitoring your payments. By seeing what is going through successfully and what is not can help you decide what you need to do differently. It could also alert you of changes you weren't aware of.
9. Automate- Automate processes wherever possible to optimize efficiency. This ties in with using technology properly because it is one of the best places to look for automation opportunities. However, be sure to be cautious when doing so because information can get lost if not carried out properly.
10. Focus on Front End- The back end of the revenue cycle tends to take most of the blame for claims improperly billed, but the revenue cycle is a team effort. The billing team can only go so far without the correct information being provided by the front end. Be sure to have processes set in place so that information about the patients is taken in accurately with each encounter.

References

10 Strategies to Improve Revenue Cycle Management. https://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/10-strategies-to-improve-revenue-cycle-management.html. 

Billing vs RCM | Medical Practice Partners. https://www.medicalpracticepartners.com/revenue-cycle-management-vs-billing/.