Revenue cycle management is one of the most important parts of the healthcare industry. Unfortunately, major reforms in the system don’t happen overnight.

If you are having difficulties with your revenue cycle and want to fast-track it, you will need data to back up the need for those reforms. After all, you can’t manage what you don’t measure.

So the first step is to develop and track some key performance indicators (KPIs) to evaluate how the finances of your clinic or private practice are going.

What is Healthcare Revenue Cycle Management?

If you’re still wondering what is revenue cycle management or RCM, it’s best to start from scratch. This is the name given to the entire financial process of a healthcare facility. The goal is to track all the steps of patient care from appointment scheduling to the final billing.

Revenue cycle management handles the following processes:

  • Patient Registration– Up-to-date patient information is essential for subsequent billing.
  • Coding– All procedures and diagnoses are translated into coding. This helps to determine the treatment cost at the end.
  • Billing– From the documentation and coding, it’s possible to bill for the services provided.
  • Posting– Payment posting is probably the most important part of your revenue cycle and a process that should be as automated as possible.
  • Accounts Receivable Follow-up– The following up on past-due accounts (something you should try to do in 50 days or less).
  • Credit Balances– Overpayments can be caused by billing or payer errors, and you must reimburse these differences to get your accounts in order.
  • Reporting– Finally, the revenue cycle must generate financial data for your taxes and audits.

Revenue Cycle Challenges

Revenue cycle management involves several important steps. In each of them, it is possible to have problems that compromise the entire chain. Today, these are the main difficulties faced by healthcare providers with their revenue cycle:

  • Data consolidation across multiple payment vendors.
  • Inaccurate coding can compromise accurate billing.
  • Inefficiency to exchange information because of disconnected or outdated systems.
  • Difficulties dealing with patients’ personal information.
  • Missing or incorrect charges can impact your budget.

Data-based Strategies to Boost Revenue Cycle Management

Now that you know the process chain and understand the number of problems that can happen, take a look at these 5 data-based approaches that can lead to a more efficient revenue cycle management.

You will need to seek out powerful and effective tools to implement these strategies in a way that best fits your clinic or practice. The investment should pay off quickly when your revenue cycle is working clockwise.

1. Offering Financial Estimates To Patients

According to a Transunion survey, 74% of younger patients didn’t pay their healthcare responsibilities in full in 2016. One way to change this is to adopt software tools to prepare cost estimates and communicate to the patient an accurate estimate of their financial responsibility. This way it’s possible to increase collections and improve price transparency and patient satisfaction.

2. Implementing Data Interoperability Systems

Interoperability is the possibility of real-time data exchange between different digital systems. Even if they speak different programming languages, the incoming data is instantly interpreted, presented, and received. Many healthcare facilities still adopt outdated systems that do not allow interoperability with other platforms. This can be very disruptive in the process of obtaining information about patients or even registering claims. Do your best to provide data interoperability systems on your part.

3. Gather Data To Create More Patient-level Care Pathways

The digitization of health processes (such as Telehealth and electronic health records) allows health providers to have faster access to clinical records and understand the previous patient journey even before their appointment. This “digital footprint” allows healthcare providers to gather and analyze data to understand treatments that the patient has already had, medications they have taken or are taking, etc. It allows for a closer and more personalized relationship with new patients.

4. Use of Data Analytics To Identify Revenue Leakage

Revenue leakage points are those steps in the process where you are losing money for some reason not always identified. Adopting data analytics is a more efficient way to identify these problems than manual audit reviews or spreadsheets. Based on the information recorded by the software, you will be able to find out if the revenue leakage occurs because the patient didn’t pay, the pricing was wrong, etc. Furthermore, automation apps can retire your manual billing process and avoid human errors.

5. Consolidate Accounts Receivables From Multiple Vendors

If your clinic has a receivables process involving multiple vendors, things can get confusing at some point. Dealing with different vendors means dealing with different methodologies, interfaces, and data types. It’s more convenient to implement a system that allows practitioners to view, sort, and compare data from various vendors all in one place than to try to organize it separately and manually.

Find and Rescue Lost Revenue

When your revenue cycle management isn’t working properly, you end up creating a series of revenue leakage points in your finances.

This can happen for many different causes, but they are usually associated with human error or the insistence on keeping complicated billing processes manually.

Your revenue cycle management needs to be flawless. For that to happen, the fastest, most efficient solution is to adopt a digital system that allows you to analyze and monitor the billing process from start to finish.

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