7 Ways to Boost Your Revenue Cycle Management
The New Year is right around the corner, and with it comes a time to reflect on what revenue cycle management (RCM) processes worked well in your medical practice and which ones still need improvement. Healthcare revenue cycle operations form the foundation of your business. Making time to assess revenue cycle performance can significantly improve your financial sustainability.
Focusing on revenue cycle performance improvement
Gather clinical and administrative staff together to reflect on the previous year using the following seven questions for discussion.
[Note: You may want to provide these questions to everyone in advance, so they have a bit of time to prepare their thoughts.]
1. What was the most significant RCM lesson learned? In revenue cycle management, learning from mistakes is everything. Maybe you uncovered a pattern of underbilling or overbilling evaluation and management (E/M) codes, so you provided practice-wide education and started auditing claims more regularly. Maybe you learned that ongoing medical coder shortages are hurting your bottom line more than you thought and partnering with an outsource vendor was the only way to sustain smooth cashflow. Maybe you learned that value-based contracts can really increase your profitability. Or maybe it’s just the opposite—the value-based contract you hoped would pan out didn’t yield as much of a bonus as you thought it would, and now you’ve got to figure out why. Dig deep to uncover what you learned about healthcare revenue cycle operations and how you grew—or plan to grow—from the information.
2. What was the biggest RCM challenge? While revenue cycle staffing challenges resonate with many, there are plenty of other healthcare revenue cycle operations challenges that may top your list as well: Prior authorizations, patient collections, increased claim denials, uncompensated time, and more. What will you do differently in the New Year to address these challenges head-on and support revenue cycle performance improvement?
3. What was the greatest RCM success? As you reflect on challenges and lessons learned, giving equal attention to successes is important. Perhaps you reduced your denial rate for a certain payer or renegotiated that subpar payer contract. Maybe you improved a specific quality metric under the Merit-based Incentive Payment program or found a way to streamline prior authorizations for Medicare Advantage. Whatever it is, congratulate yourself on revenue cycle performance improvement and keep up the good work.
4. Did we have the right RCM technology in place? Be honest. Do your electronic health record (EHR) and practice management system work for—or against—you? Do they promote efficiency and productivity or drain them? Do they enable growth and maximum profitability? Do they cater to your individual practice and specialty needs? What about patient engagement? Do they add value? What are the biggest frustrations, and can your vendor do something to address them? Does your vendor provide enough support in general?
5. What are three words that sum up the year? Give everyone an opportunity to share their thoughts, and you might be surprised by what people say. Ask them to explain why they chose those words. Then use this feedback as you embark on the year ahead. Negative responses may highlight areas ripe for revenue cycle process improvement.
6. What are the RCM goals for the year ahead? As you look ahead, what are you trying to accomplish? And how will you gauge success? What revenue cycle management metrics and key performance indicators will you use, and what specific steps will you take to promote financial sustainability? One fun team-building activity is to create an inspirational vision board for the year ahead where everyone can contribute images, phrases, and more.
7. What will each person do to contribute to the overall financial success of the medical practice in the New Year? Perhaps a medical coder will obtain an additional coding certification or additional education to enhance compliance. A physician might team up with a coder to improve their clinical documentation. A front-desk staff member might be more diligent about collecting accurate demographic and insurance information. A medical practice manager might look for ways to improve patient flow. When everyone takes one small step in the right direction, the entire business benefits from those efforts.
Look ahead to your revenue cycle progress
Making time to assess revenue cycle management workflows, technologies, and goals sets today’s medical practices up for a successful year ahead. While there are many regulatory and operational uncertainties, proactive planning and consciously setting good intentions can help practices enter the New Year with confidence and positivity. Learn how edgeMED can help.
