Top 7 Best Practices in Revenue Cycle Management

Is your revenue cycle a mess? Are you in a pickle about how to streamline it? You’re not alone. Even though every healthcare organization must follow the same steps to manage their revenue cycle, many seem to struggle with the process.

We’ve curated this list of top 7 revenue cycle best practices to help you truly understand how revenue cycle management works.

Best Practices in Revenue Cycle Management

Both chronic diseases and the number of patients in hospital are increasing every day with an ageing population. Under these circumstances, revenue cycle management can become overwhelming. These revenue cycle best practices can help you successfully streamline the process.

Trained Professionals for Productivity Management

Ensuring productivity at each step of the revenue cycle is a major challenge. It helps to only hire trained and experienced staff to sustain a productive revenue cycle. A person should have the necessary knowledge and skills to handle operations (billing, coding, claims) assigned to them. They must be good at time management and ensure high accuracy in task delivery.

Physician Enrollment for Quality Service

Physician credentialing is often ignored as far as revenue cycle best practices are concerned but know that it is a critical part of successful revenue cycle management. If you don’t enroll physicians in a timely fashion it can translate to revenue loss, payment delays, claim denials and inefficient services.

For this reason, it pays to invest time and manpower on physician credentialing and enrolment.

Accuracy for Denial Management

Inaccuracy in coding and billing operations can impact a healthcare practice’s reputation. Any mistake in the coding process can lead to a delay or denial of claim settlements. To avoid errors:

Review claims in batches

  • Verify the data and benefits prior to claim submission
  • Notify hospital staff immediately about electronic remittance advice
  • Communicate payment options clearly to patients
  • Expand modes of payments to facilitate quicker payments

Provide a proper explanation for denied claims and prioritize submission to avoid huge bills.

Account Receivables (AR) for Timely Payments

You can determine the efficiency of payment collections by calculating the AR percentage. The more AR you can maintain within a 90-day period, the better your bottom line and revenue cycle success will be. Usually, the factors that impact payment collection include staff efficiency, aged claims, settlement denials, bill payments, etc.

According to the Medical Group Management Association (MGMA), A/R should not exceed 12-14% across a 90-day period. Anything more reflects an inefficiency in follow-ups and high denials.

To maintain AR, review denied settlements and contracts once every week. Identify trends that may be leading to denials and work on avoiding them in the future.

Electronic Health Record (EHR) for Quality Patient Care

EHR refers to a systematic collection of patient data and medical transcriptions— personal information, pharmaceutical or medical history, scan reports and much more. EHR can easily be shared across a network of healthcare service providers who can track patient records to fulfill their requirements.

EHR helps healthcare practitioners offer quality services to patients and maintain report accuracy. Specialists can also study different EHRs to identify and suggest proper therapy to patients.

Given that EHRs are stored electronically, there is no need for manual modification or storage of patient information.

Patient Eligibility for Convenient Billing

The most important revenue cycle best practice is patient eligibility verification. It can help facilitate quick claim settlements, convenient billing, easy payments and management of the entire revenue cycle.

Patients who opt for high-deductible insurance plans are typically oblivious that they need to pay for services upfront. Verify patient eligibility to tackle this issue. It will help you clearly communicate the cost of service appointments to patients.

Customer Satisfaction for Reputation Management

The reputation of any healthcare practice relies on customer satisfaction, which ends up being a mix of these factors;

  • Duration of claim submissions
  • Ability to manage denials
  • Ability to handle resubmissions or appeals
  • Patient Information and Data Security

Any healthcare practice with a good customer satisfaction rate will have a successful revenue cycle. To ensure customer satisfaction, medical practices should be well-informed about the latest trends and technologies in the industry. The ability to provide patients the right input will give you a competitive edge.

If you follow all the key components of revenue cycle management, you’re one step closer to achieving success for your healthcare business.

Streamline Your Revenue Cycle Management with HelioNext

HelioNext can help take the hustle out of revenue cycle management. We don’t just monitor your revenue cycle, we manage it.

Partner with us to manage each step of your revenue cycle right from patient admission, appointment scheduling, treatment and coding to billing, claim settlement and payment.

Get in touch today.