Put these 7 revenue cycle management goals on your list for 2023
Many of today’s medical practices struggle to improve financial performance and maximize profitability. Of course, the intention to improve revenue integrity is there. That’s not the issue. Instead, it’s often a lack of direction that stalls progress. Everyone can agree they want to reduce denials, for example, but the practice doesn’t set a specific goal, invest in the right technology, or hold staff accountable.
Now is the time to change that.
With the New Year comes the ability to start with a fresh slate after medical practices have had a strong financial end to 2022. Here are seven revenue cycle management (RCM) goals for 2023 that should be on every medical practice’s radar.
1. Monitor contract underpayments. Few medical practices take this added step to ensure revenue integrity; however, it’s important an important one. Why? Because it prevents you from leaving money on the table. To improve financial performance, unpaid and underpaid claims recovery should be at the top of a medical practice’s priority list in 2023.
2. Identify new revenue opportunities. This could be anything from chronic care management to transitional care management to advance care planning to ancillary services, and more. The idea is to attract new patients to the medical practice and promote loyalty with existing ones. Performing a cost-benefit analysis is a good first step. Be sure to understand medical coding and medical billing implications of these services.
3. Focus on enhanced charge capture. Improving financial performance could be something as simple as making sure you don’t routinely forget to bill for certain charges. For example, this might include administration codes for vaccines and medications, medications for nebulizer treatments, and more.
4. Enhance the patient financial experience. For example, does your medical practice offer online patient bill pay? Can it send patient statements via mail, email, and text message? Keeping patients engaged and informed goes a long way in terms of improving overall financial performance.
5. Perform medical coding and medical billing audits regularly. Ongoing audits are the only way your medical practice can identify potential medical coding and medical billing problems proactively. In 2023, commit to at least one audit per quarter so you can uncover and address hidden medical billing and medical coding compliance vulnerabilities. It’s all about proactive denial management and mitigation.
6. Leverage data analytics. You can’t possibly monitor aging accounts receivable (A/R), stay on top of unbilled encounters, determine the cause of denials, and address rejected claims if you don’t have a good handle on your data. Heading into the New Year, investing in a full suite practice management and electronic health record solution may be a very wise decision.
7. Improve front-end processes. Successful financial performance begins with sound demographic and insurance information. Using mobile check in can reduce staff data entry errors. In addition, plan to invest in staff training regarding the importance of real-time eligibility verification, prior authorizations, secondary insurance information, and more.
Setting ‘SMART’ goals
Note that you should further refine these goals so they adhere to the ‘SMART’ acronym (i.e., specific, measurable, attainable, relevant, and time-based). For example, regarding the goal to identify new revenue opportunities, consider something like ‘In the next three months, we’ll perform a cost-benefit analysis for two new potential revenue opportunities.’ Regarding the goal to monitor contract underpayments, consider something like ‘Uncover at least 25% more underpayments in the first six months of 2023.’
Getting the entire team on board
Once you identify SMART goals for your medical practice, make sure everyone is aware of these goals and the role they play toward achieving them. Be prepared to explain the logic behind certain goals. For example, if your goal is to improve charge capture by 25%, perhaps that’s because you’ll be leveraging RCM technology that automates some of the process. Or if your goal is to reduce A/R days, that’s because you’ll be leveraging RCM technology that speeds up the payment process. Hold employees accountable, and measure progress along the way.
Conclusion
Setting financial goals for 2023 is an important part of improving financial performance. Without specific goals, medical practices may not see desired results. Learn how edgeMED can help your practice meet many of the goals discussed in this article and be sure to check the Healthy Snacks blog for more expert insights, best practices and industry trends.
