How to Increase Healthcare Revenue: 5 Practical Tips

Building a strong revenue cycle and providing quality care are two of the most important responsibilities of healthcare organizations. The 2020 CAQH Index indicates that the healthcare industry could save nearly $16.3 billion in administrative transactions by switching to electronic transactions. The same study also shows that medical representatives spend roughly 11 more minutes on average conducting eligibility and benefit checks manually. It’s also worth noting from the study, that while the healthcare industry is making progress in automating its administrative tasks, there are still plenty of opportunities.

If we were to take other processes such as inaccurate coding and patient collections into account, consider the losses that might be incurred. . It’s evidently not very challenging to determine the importance of enhanced revenue solutions in the healthcare sector. Here are 5 ways to improve revenue cycle in healthcare:

Be transparent about potential treatment costs

Given the dominance of highly-deductible insurance plans in the market, patients need to cover a huge percentage of the total bill. According to the Consumer Financial Protection Bureau (CFPB) estimate, medical debt in the U.S. rose by about $88 billion in 2021. The same report stated that one out of every five households is in medical debt. Implementing carefully-planned strategies can avoid medical debt piling up and help to increase practice revenue.

Strategies may include providing a treatment estimate to patients beforehand, so they can make informed decisions about pursuing care. Corroborating this, MedData survey shows 62% patients agreeing to knowing expected out-of-pocket costs impacts the decision to pursue care.

Healthcare organizations must make pre-service or upfront payment options available to patients. They should also educate medical staff about meeting compliance requirements and providing prompt updates to patients about overhead costs.

Accelerate processes and save costs with automation

Manual processes in revenue cycle management consume time, raise the possibility of errors and are expensive. Automated processes can accelerate communication with patients. Error-free and electronic health records are necessary to validate patients’ claims for the treatment they have received.

Introducing automation in hospitals can increase practice revenue by saving costs and ensuring smooth integration of documentation systems, billing invoices and claims.

A survey by AKASA showed, automation implementation in revenue cycle operations rose by 12% in 2021 compared to 2020. It highlights that nearly 66% of healthcare systems and hospitals use automation tools as one of the ways to increase medical practice revenue.

All revenue cycle strategies must prioritize quicker reimbursements from insurance companies. Automation can ensure proper management of prior authorizations, claim submissions, medical bill generation and insurance follow-ups.

According to the 2021 CAQH Index, use of automation in prior authorizations increased by 5% in 2021 compared to 2020. This led to a decline in spending of 11%. Findings from the same report indicate:

  • Healthcare organizations saved up to 16 minutes per pre-authorization
  • Adoption of automation in the claim submission process increased by 13% in 2021 compared to 2020. This increase in automation usage can result in cost-savings worth approximately $1.7 billion.
  • Implementing automation can also improve operations of the medical billing department

Speed up reimbursements and avoid fatal consequences with correct coding

The consequences of inaccurate coding can be fatal— aspects of financial, legal and quality of care. Any delay with reimbursement collection, denial of claims, filing of fraud claims or any other consequences could lead to the revenue cycle collapsing.

For this reason, one of the ways to improve revenue cycle in healthcare is to add additional resources in investigating such consequences. Assigning correct codes to claim documents will lead to rapid approvals. Subsequently, insurance companies can reimburse claims on time.

Healthcare organizations need to employ coding experts with up-to-date knowledge of leading coding systems. Implementing automated solutions can also help improve the accuracy of codes and speed up reimbursements.

Automated systems work on machine learning algorithms. Of the 100,000 codes in the International Classification of Disease (IDC-11) coding system, these systems can identify and assign the correct code and regulate the revenue cycle.

Outsource RCM processes to focus on patient care

Hiring enough professionals and arranging resources for revenue cycle management (RCM) may not be possible for every organization. Lack of expertise and skilled IT talent may lead to weak revenue cycles. Inevitably, it can lead to adverse impacts on patient care. For this reason, it is practical to outsource RCM processes.

According to the research and consulting firm IMARC, the healthcare RCM outsourcing market has contributed $20.1 billion in 2021. The same report states that industry revenue is estimated to reach $53.5 billion by 2027.

RCM providers ensure that the revenue cycle of healthcare setups is managed by experienced professionals and the latest tools. For this reason, HCPs, hospitals and clinics can provide quality patient care without worrying about billing practices, coding, or denial management. Outsourcing RCM process is a smart strategy for saving time and improving revenue cycles.

Track progress of each process

One of the simplest ways to improve revenue cycle in healthcare is to track the progress of each process, ranging from billing cycles to payment policies. Determining areas of improvement will help devise solutions to eliminate process loopholes. Adopting a preventive approach is effective as it provides ways to ensure a steady cash flow which in turn helps detect issues before they escalate into legal risks.

A weak revenue cycle management can affect every aspect of a healthcare organization.

Having read these tips on how to increase healthcare revenue, we understand that you may have some questions. We have attempted to answer some of the frequently asked questions for you below.

Q. How to find an appropriate outsourcing partner?

You can approach different outsourcing partners based on the size of your organization, assigned budget and required solutions. Perform thorough background research, track records and analyze quality of services provided by these partners. Select a partner that meets your requirements and adds value to your organization.

Q. How to increase healthcare revenue?

Sharing clear treatment estimates, adopting automated systems and outsourcing RCM are a few ways to improve revenue cycle in healthcare.

Q. How to increase healthcare revenue by using automation?

Automation can be implemented in every revenue cycle operation. From scheduling appointments, medical coding to tracking claim generation and documentation, automation can streamline workflows to save time and deliver the best results.

In our current scenario, all healthcare setups must focus equally on increasing revenue and offering quality patient care. Hopefully, you can benefit from one or all five ways to improve revenue cycle in healthcare, shared above.

HelioNext is a leading RCM solutions provider. We have been developing end-to-end, customizable revenue management systems to suit the needs of our healthcare clients for over 15 years. To learn more ways of improving revenue cycle in healthcare, get in touch with our experts today.