Health care revenue is complex, involving a variety of components from patient access and registration to medical billing and coding. Ensuring your providers get paid quickly and accurately is dependent upon an efficient health care revenue cycle. But achieving this proves difficult to many providers, especially those with larger facilities spread out over multiple locations.
Prioritizing Revenue Cycle Efficiency
Many of the trends in health care today make it difficult for providers to remain financially healthy. With more of an emphasis on patient financial responsibility and a move toward value-based purchasing, providers are increasingly relying on payers and plans for reimbursement – and those are often closely linked to their clinical and financial performance. It’s no wonder operating losses per physician rose to 17.5 percent of net revenue in 2017 – a statistic that drives home the importance of prioritizing revenue cycle efficiency in order to remain fiscally healthy.
Strategies that can help you accomplish this include:
- Automation. Experts point to automation as the key in streamlining the revenue cycle process and improving productivity and efficiency. With an emphasis on technology in the health care sector, automation is a natural fit – yet many providers stubbornly rely on paper-based systems (31 percent, according to results of a recent survey. Switching to automated claims management processes for work such as prior authorizations, claim submissions, and claim payments would save providers $8.5 billion annually, according to the Council for Affordable Quality Healthcare, and would greatly reduce the administrative burden on health care professionals, leading to reductions in human error and labor costs. Integration with legacy systems and their EHR data would go a long way toward achieving this.
- Front end processes. Experts believe nine out of 10 claim denials are preventable – yet hospitals and health care systems are writing off 90 percent more of these claims as uncollectable compared to six years ago. This could largely be avoided by making an effort to improve front end processes that result in many of the common errors that lead to claim denials and other backend issues. Implementing automation can reduce a number of common errors that lead payers to deny claims, such as missing or incomplete patient information, prior authorizations and verification of benefits.
- Price transparency. With the burden of health care costs increasing falling on the patient, it’s important to ensure your pricing is as clear as possible in order to improve collection rates. Tactics include providing cost estimates of services in advance, offering convenient payment options, and automating the medical billing process. Taking these steps facilitates faster revenue collection and makes it easier for the patient to understand up front what their financial responsibility will be.