Strategies to minimize revenue loss in Medical Billing
Healthcare CFOs must take the tough decision of writing off claims when they are unpaid for a long time. Delays in accounts receivable follow-up reduce the possibility of getting paid, and hence, speed of response and effectiveness of follow-up is essential.
Healthcare providers must focus on delivering high-quality care while the revenue cycle team manages the reimbursements. As healthcare CFOs focus on implementing robust denial and A/R management processes, hiring high-quality resources is essential and can be challenging as the nation faces an unprecedented labor shortage. Outsourcing accounts receivable and denial management processes to a seasoned outsourced revenue cycle services provider can minimize revenue loss and improve financial outcomes.
Let’s look at key strategies to control revenue leakage in the revenue cycle: below:
Implemented structured processes to manage denials
Rejection management is a necessary process. Paying attention to the rejections from the clearinghouse and alerts from the RCM system can save a lot of time and costs. Further, by taking an 80:20 approach, RCM managers can enable their team to focus on the top 20 reasons causing 80% of denials.
Hospitals and health system CFOs can shift focus to denial prevention by implementing processes that facilitate a dialogue between the clinicians, front-end, and mid-cycle team members. By reviewing the root cause of denials and focusing on eliminating the root cause through behavioral and systemic changes, the revenue cycle team can eliminate many of the preventable causes of denials.
Achieve efficiency and reduce costs by outsourcing your revenue cycle processes
Healthcare leaders adopt outsourcing to gain access to denial management and coding talent. Seasoned service providers bring a culture of denial prevention by progressive elimination of root causes of denials. Their data-driven approach can help healthcare organizations accelerate cash flow and improve reimbursements.
Hospitals bleed over 3-5% of their revenue due to revenue leakage. These are primarily on account of inefficient clinical documentation and missed procedures. Expert medical coders work alongside clinicians to focus on clinical documentation issues to reduce Discharges Not fully Billed (DNFB). After implementing periodic physician education programs, most hospitals have reported a significant jump in revenues.
Efficient revenue cycle processes improve all business and financial outcomes, including improving patient experience, speed, and access to care. Issues such as delays in physician credentialing, patient eligibility and benefit verification checks, and prior authorizations are the top issues for claim denials. Often, these issues are due to a lack of structured processes or inadequate staffing. A great RCM partner can eliminate these issues and enable you to find the resources and investments you need for other pressing needs.
Involving your revenue cycle workforce
Revenue cycle management is a team sport. Establish key performance indicators for all component processes through the front-end, mid-cycle, and back-end revenue cycles. These KPIs will help you measure the efficiency and effectiveness. of each component process. Involve your team members in reviewing these KPIs’ current state and establishing a process for continuous improvement. Identify the weak links in your process chain and provide remedial interventions such as tools, training, and additional workforce, where needed.
Implement Robotic Process Automation
These are challenging times for people leaders across the world. The great resignation and shifting labor dynamics have forced them to look at ways to improve human and machine efficiency. Many business process experts consider process automation a critical enabler in this journey to avoid manual work and improve efficiency.
Robotic process automation anchored on machine learning and artificial intelligence can automate many of the routine tasks performed by the RCM workforce or reduce the number of steps taken in an activity. RPA can save a lot of manual effort, time, and money, if implemented correctly.
Healthcare CFOs can make a prudent choice by relying on their service provider’s RPA stack and engaging in a more productive discussion on reducing the total costs with their service provider. By structuring RCM outsourcing engagements on contingency-based deals, they can extract the best value from the partnership and avoid investments in RPA technology. This strategy avoids investments in RPA technology and accelerates your journey to getting the best-in-class RPA technology without going through the challenging phases of implementation and maintenance.
Conclusion
Progressive healthcare CFOs are shifting their focus to revenue improvement by finding opportunities to change the status quo. Coordinated processes, collaborative team structures, efficient tech, effective measurement processes, and great partners - that, in essence, is the summary of the strategies revenue cycle leaders can adopt to bring about dramatic improvements in the financial health of their healthcare entities.
If you are looking to improve the financial health of your healthcare practice, hospital, or health system, we can help. We provide trained resources, awesome tech, and a collaborative culture to eliminate revenue leakage and put your organization on the path to profitability. Call us at +1 (718) 249 2245 and write to us at info@medicalbillingwholesalers.com
To learn how Medical Billing Wholesalers can help your healthcare organization achieve financial success, visit https://www.medicalbillingwholesalers.com
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