Many healthcare organizations and practices faced some serious funding challenges, and many organizations entered 2021 operating within limited budgets — creating contingent revenue cycle management (RCM) strategies to ensure that opportunities are seized. As a result, healthcare providers need to consider necessary changes to maintain revenue. While change is never easy, it’s never too late to improve the content of your practice.
What care providers can do now is tackle the areas that will have the biggest economic impact to stay ahead of the competition, despite strategizing the ways without losing revenue.
Revenue Cycle Management
Patient satisfaction is important to your bottom line — after all, medicine is a people-oriented business. You want to provide exceptional customer service to your patients, but your commitment to service excellence must be based on your ability to balance providing an exceptional patient experience with providing quality service.
With an emphasis on delivering great patient experiences to achieve better financial results in today’s turbulent marketplace, there has never been a more important time to focus on revenue cycle productivity. As hospitals and healthcare organizations make this transition from revenue cycle management (RCM) to optimization, many have yet to decide what “big” looks like for their organization – or what strategy and resources are needed to get there.
Main Areas of Importance
There are three main areas of importance in this study:
1. End-to-end best practice
While many health systems have established the most important KPIs for leadership, the best ways to implement these KPIs remain a challenge. It’s important to have clarity on how each type of approach relates to creating simple and efficient business processes – free of complexity and manual or repetitive tasks. The processes that drive each of these KPIs and the associated end-to-end business processes must be clearly defined and standardized.
Hospitals also need to continue to invest in staff training tailored to specific roles, so all stakeholders understand the processes in their respective fields, and how their actions affect revenue upstream and downstream.
2. Group specializing in revenue cycle
Due to the limited resources of healthcare organizations and the inherent complexity of the revenue cycle, RCM teams bear increased pressures and job responsibilities. This situation reduces them to highly trained specialists with a laser focus on their specific performance specifications. For example, during the height of the COVID-19 crisis, many hospitals increased telehealth use and rapidly implemented digital registries.
Several strategies had to be modified or added; training was needed in areas such as patient attendance, coding, and billing. Without specialized staff, healthcare teams would not be able to adapt as quickly, potentially disrupting revenue, revenue, and patient experience.
Resources Revenue Cycle Management
When resources are limited, attracting qualified professionals at the top of their field can be difficult. Fostering a more competent team improves productivity in several ways: improving consistency, ensuring appropriateness, and encouraging good decision-making when issues arise. For example, employee claims specialists can save immeasurable time and money by troubleshooting denials and avoiding the cost of delays.
They can stay abreast of changes in reimbursement guidelines to ensure the successful completion of their work in response to the evolving needs of payers. As emerging challenges such as value-based care and consumerism increase the complexity of some projects, a professional strategy with a core strategy is essential.
3. Technology drive Optimized end-to-end performance
Laminate or bolt-on technology is an increasing barrier to revenue cycle performance. Integration is often more complex and expensive than planning and does not provide the desired flexibility of communication. Tasks involving managing multiple vendors also take time away from revenue-generating activities. Providers also rarely account for how multiple programs can lead to negative outcomes in management strategies, barriers, and routine services. For example, even if a system is great at being able to manage patient accounts online, it has only increasingly lacked even best medical billing company practices hardwired into the technology to ensure basic revenue cycle processes are sound as billing, coding and complete details.
Health Systems
Today’s hospitals and health systems need to partner with a revenue cycle partner that has invested millions in a combination of digital capabilities and leading interdependent technologies (e.g., optical character recognition, natural language -improved its intelligent automation offering to include processing, machine-learning works with RPA).
The IA ecosystem that owns and harnesses these technological compounds helps support health systems to divert waste from various revenue cycle processes to create greater potential in operations. And while most revenue cycle initiatives can be fully implemented, there are still exceptions that require human intervention. There is a need for a combination of IA technology and business processes that can provide a seamless handshake between digital agents and people to ensure speed, accuracy, and consistent productivity across the enterprise.
Customized Process of Wise Medical Billing
- A well-managed IA platform provides customized processes that patients can rely on, all filtering out common administrative errors or performance-related issues that can significantly increase revenue for the health system. With the high costs associated with developing this technology internally, or working with multiple vendors, health systems need a partner that can deliver a proven IA process, teams of multiple employees with subject matter expertise, and analytics which is needed to foster a culture of ophthalmology medical billing and seniorcare continuity.
