5 Tips to Improve Your Revenue Cycle Management

Healthcare spending in the US is monumental. It averages out to around $3.8 trillion annually and will likely continue rising for some time to come.

Of course, that spending is spread out across countless hospitals, private practices, and associated healthcare service providers. It’s also complicated by the intersection of private insurance coverage, self-pay, and government insurance payments. That means hospitals and other healthcare providers need solid revenue cycle management.

What is revenue cycle management? In broad terms, it’s the administrative process you use to track and manage that intersection of billing and payment to ensure your services actually generate revenue. Since you can improve on all processes, keep reading for five ways you can improve your revenue cycle management.

1. Map Your Process

Every time an insurance company changes its policies or the government creates new regulations, it can alter your health revenue cycle process. While each change can feel minor, the accumulation of changes can leave you in the dark about how your own administrative functions work.

Map out the entire process you use for revenue cycle management. That mapping process can expose redundancies or errors that can improve your revenue stream.

2. Create a Dashboard

Too many in the healthcare industry find themselves with revenue cycle information spread out across multiple applications or in information silos. You need one dashboard that lets you give an overview of your entire cycle and highlights key metrics, such as claim denials. This lets you pinpoint weak areas in your process and correct them.

3. Training

You cannot expect great results from employees who lack the right skills for a job. That proves as true in healthcare management as it is in any other industry. For example, you can’t buy new medical coding software and expect that employees will figure it out as they go.

When you ask employees involved in the health revenue cycle to take on new duties or deal with new software, make sure they get the right training.

4. Work the Data

You collect a lot of information from your customers. Work that data to see what it can tell you.

Do you see a lot of denials from one insurance company? Do you have trouble collecting from Medicare or Medicaid? This information can clue you in to non-obvious problems in your process.

5. Get Outside Help

Like many administrative tasks, you can outsource some or all of your cycle management. Before taking that nuclear option, consider bringing in revenue cycle management consultants. They can analyze your current process and make recommendations for streamlining or updating it.

Upgrading Your Revenue Cycle Management

Good revenue cycle management can mean the difference between running in the black and closing your door the following year. That means you cannot treat your process as an afterthought. You must spend time with it, understand your own process, and correct weaknesses that you find.

That may mean getting training for your employees. It may also mean seeking outside assistance in the form of consultants. In the long run, though, your improved bottom line should offset the costs.

Looking for more finance tips? Check out the articles in our Finance section.

Bruce Reyes

Bruce Reyes