4 Steps to Guarantee Improved Healthcare Revenue Cycle Management

Identifying the root cause of payment problems is critical to collecting all possible reimbursement. With costs rising and payments decreasing, inefficiencies and billing errors can be catastrophic if they go uncorrected.

Collect Patient Information to Avoid Delays with Claim Reimbursement

Collecting accurate patient information at the outset of the relationship between the patient and healthcare organization is of the utmost importance, as this information is the base of billing and collecting. Comprehensive patient registration is one of the main factors in efficient healthcare revenue cycle management. The patient’s demographic information must be entered correctly into the billing system, and the front-end staff must verify health insurance eligibility and up-to-date coverage information with insurance companies.

Inform Patients Of Their Financial Responsibility to Ensure Smooth Payment Collection

According to the Center for Medicare & Medicaid Services, approximately 12.7 million people selected a high-deductible insurance plan during the 2016 open enrollment period. This means that there is a widespread increase in patient financial responsibility. To avoid delayed or delinquent payments that can negatively impact healthcare revenue cycle management, healthcare organizations should develop policies and procedures for providing patients with accurate cost estimates and the terms of their responsibility.

Automate the medical billing and claims management process to relieve administrative burden

Claim submission is a complex, bureaucratic process. It requires extensive data collection, effective communication between staff across multiple departments, and management procedures for claim denials. According to HIMSS Analytics, over 30 percent of providers have yet to automate the claims management process and are still operating manually. With automation, the labor-intensive claims process becomes streamlined, and more easily monitored and improved.

Ensure Accurate Coding to Avoid Billing Errors

Accuracy in coding helps to ensure efficient healthcare revenue cycle management. According to the American Health Information Management Association, some of the most significant coding challenges include:

• Insufficient documentation of grafting materials and devices
• Mistaking the use of guidance tools
• Improper use of procedure codes for diagnostics
• Neglecting to apply the accurate number of characters for trauma and fracture codes

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