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    5 Ideas for Optimizing Healthcare Revenue Cycle

    npsBy nps12 September 2021Updated:4 July 2024 No Comments4 Mins Read
    — Filed under: Focus
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    Like most countries in the world, the US health system is struggling thanks to the COVID-19 pandemic. As patients keep postponing their medical appointments, healthcare facilities shoulder the burden. From financial constraints to medical staff being laid off, it is no surprise some medical facilities are shutting down.

    But by adopting a revenue cycle for healthcare, they can prevent these losses. Here is how:

    Revenue - Image by aroblesgalit from Pixabay

    The strategies for optimizing revenue cycle for medical facilities include:

    1. Automating workflow

    Doctors, nurses and lab specialists perform repetitive tasks every day, which sometimes can be overwhelming. The scenario applies to the medical revenue cycle department. Besides confirming if a patient can pay for a specific procedure, the team also follows up on their medical coverage. These back-and-forth activities are enough to cause burnout for employees.

    Sometimes, it gets daunting to figure out which patient deserves the type of service from those who can wait unless you automate the workflow. When the workflow is computerized, the team will have time to focus on the most critical activities. The result is increased productivity.

    2. Streamline collaboration from the front to the back

    Assuming the front office involves medical team members attending to patients’ needs directly, the finance department is obviously at the back. The former collects patients’ information, book their appointments, verify if they are qualified for specific treatments, and register guest patients. On the other hand, the latter takes care of bills, claims, denials and other financial commitments on behalf of patients.

    For both departments to work synergically, the revenue cycle must come in handy. Both parties can communicate effectively, leading to precise, prompt and better collections. Computerization also makes it easier for both of them to solve a problem as soon as it arises.

    3. Computerizing activities that the front-end providers perform

    In a hospital with many patients, it is easy for a front-end provider to miscalculate or create errors when booking a patient. Perhaps, they were so overwhelmed with hundreds of patients who were streaming into the hospital. In the end, the finance department might not track all activities and make accurate decisions concerning payment or reimbursements.

    Sometimes, problems like wrongful identification of patients and claim denials might arise. Fortunately, revenue cycle management can prevent all that. Since it is all about preventing such errors from cropping up, the hospital can provide patient-centered services instead of settling scores.

    4. Tracking patients’ payment history

    One way lending institutions determine if a borrower is eligible for loans is by tracking their credit history. The same applies to revenue cycle managers who are tracking a new patient’s payment history.

    Medical record - Image by vjohns1580 from Pixabay

    However, accessing such sensitive information can be costly for any medical facility. The more they automate their tracking methods, the better they will prevent hiccups and other errors in the future.

    5. Reviewing and ensuring processes are up-to-date.

    In a hospital setting, anything out of the norm can happen, from patients dying to wrongful registrations. It makes sense for providers to review these processes and ensure they are up-to-date daily. That way, they can identify a problem and solve it before the next day. It is a preventive approach that works by automizing and updating digital processes regularly.

    Review - Image by aymane jdidi from Pixabay

    Optimizing staff activities also prevents denial issues. Once they identify a problem, they work as a team to solve it before it escalates. Consequently, their collaborative approach to finding solutions improves the revenue cycle for the better.

    How can the healthcare system benefit from the revenue cycle?

    The revenue cycle system in a healthcare department involves streamlining the chain of events from when a patient books an appointment to when they receive their bills. It starts with a hospital optimizing its operations to earn more profits. The aspect of revenue cycle also profits a patient if the hospital has awarded them with reimbursement which is a win-win for both parties.

    These strategies for optimizing revenue cycle management can only apply if providers work as a team. As long as the front-end and back-end staff understand the perks of RCM, they will be more productive. They should be ready to accept the new way of doing things to improve their productivity. The top-level management should also organize technical know-how training programs for their staff. Once this is ingrained into the system, providers can focus on providing excellent patient care.

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