How Can a Healthcare Organization Improve its Revenue Cycle Management?

by: admin Healthcare Ethics‚ Healthcare Research Comment off

As healthcare facilities seek better means to influence reimbursements, revenue cycle approaches provide the opportunity and way to improve cash flow. It further improves efficiencies through better employee education. The revenue cycle is a complex system that offers several opportunities for hospitals to create efficiencies and cost-savings.

However, many organizations forgo improving the revenue cycle and instead focus primarily on cost cutting. Physician practices are being called on to do more than ever before. Today’s physicians must treat more patients; document exchanges more accurately; dispute with more complex managed care rules; keep track on an ever-increasing collection of drugs; submit and track claims and pay rising malpractice insurance bills. In many cases though, physicians must treat at least 20 percent more patients than they did five years ago. This helps to generate the same income. In the face of these burdens and difficulties, some practices are stressed to remain financially feasible. For many practices and facilities, the biggest impairment to gathering these challenges is continual administrative burden—a lack of automated clinical documentation, and inefficient Practice Workflow Systems (PWS). Despite the dramatic advances in many areas of healthcare technology over the past several years, most physician practices especially small and midsize ones are still using the same manual and paper-based office management systems they’ve used for years. With increasing pressure from insurers, government agencies, patients, and physician practices need to reexamine the ways they work and interact. As physicians see more patients and insurers, demand for reformed papers for rapid dispensation of claims, the manual healthcare systems that were adequate in the past will become less and less able to meet new demands. A major path to educating Revenue Cycle Management (RCM) will be to eradicate the paperwork burden among small and mediums group physicians, which will also bring more quality of patient care. In addition, common glitches in all the revenue cycle stages include disorganizations, ensuing in delays and loss of recoverable revenue.

 Revenue cycle improvement that extend the capabilities of a hospital information systems are key to improving access organization, rejoining to healthcare consumerism; hastening cash collection and cultivating payor enactment. When it comes to improving access management, according to McKesson’s healthcare solutions, the improvement and clarifications of financial authorization allow healthcare companies to find not only insurance suitability but the capacity to pay healthcare expenses. Including medical necessity, checking during registration, scheduling and ordering can help reduce Medicare denials and increase reimbursement, by providing medically necessary services or issuing an ABN for non-covered services. Likewise, by smoothing better-quality workflow dealings while eradicating paper wastes, McKesson’s solutions to improving revenue cycle will allow physicians and hospital employees to correctly empower medical services, regulate, confirm and analyze payment risk while accessing schedule resources before patient’s arrival. In order for organizations like hospital facilities to rapidly improve and manage its revenue cycle, according to Becker’s Hospital Review (BsHR), it will be the creation of an information system that standardizes critical pieces of the process and normalizes disparate information used to monitor their effectiveness. From the moment a clinical procedure is completed to the moment when the hospital receives revenue from the payor, there should be control points and a performance monitor along the way, and newer technology systems help spur this innovation. Additionally, Ms Rasmussen from the BsHR stated that revenue cycle team members need to evolve with the system. This means there has to be a culture of responsibility and accountability among all team members. You have to have a systematic way of assuring what one need to do on a daily basis gets done and is organized in a way so as to not lose sight of organizational impacts.

Reference List: