What to look for in a revenue cycle management provider

Regardless of the business you’re in, the capability to efficiently capture, manage and collect revenue is critical to success. Many healthcare organizations are turning to revenue cycle management (RCM) vendors and their high-tech software applications to help them achieve consistent profits. The demand from home health, physician offices and hospitals has resulted in a consistent stream of new RCM companies providing these services. But how do you decide on the RCM platform that’s right for your healthcare operation? Here are the top five things to look for in a revenue cycle management provider.

1. Comprehensive, customizable applications

One of the first things you should look for in a revenue cycle management provider is a full range of RCM components. Depending on your organization’s size, your current staffing and your top priorities, you may need a customized application that is just right for you. A company that offers an “all-or-nothing” approach won’t have the flexibility to meet your specific needs. In addition to all-payer claims and remittance processes, you may need physician scheduling or Medicare eligibility verification at some point. Ideally, you want to choose an RCM vendor who can help you identify your needs and then be equally happy to partner, to consult, to co-manage or to fully outsource their revenue cycle management. Plus, if you start small, you want a provider who can easily add-on the services you need as you grow.

2. Technology and security

Rapid technology changes are common in healthcare. You’ll want to make sure you hire a revenue cycle management provider who offers the most productive and efficient technology, including cloud-based software that’s reliable, easy to use and connects to your existing software. You’ll also want a vendor who stays ahead of changes in technology, modifying their products to bring the best to their customers.

3. Trust and transparency

Your revenue cycle management provider will be critical to your organization’s overall success. That’s why both trust and transparency are so important. Do your homework and read reviews, look at customer testimonials and business case studies. Investigate the company — how long have they been operating? Who are their owners? How involved are they in the industry? What is their financial health?

With regard to revenue cycle management software, will you have full access to manage claims and pull reports? You should have transparency when it comes to knowing and understanding the work that is being performed.

4. Effective software processes

When choosing a revenue cycle management provider, you want to make sure the automated processes implemented by the software are effective and easily customizable to your specific needs. That means your RCM platform needs to support rapid turnaround time for claims, as well as a low percentage of denied claims and a process for resubmitting those claims. Find out what the provider’s denial management strategy is — what percentage of claims are denied in the first place and how many will be resubmitted? You want your RCM vendor to take an active approach to quickly submitting claims and have the processes in place to appeal denials.

5. Personalized customer service — training and reporting

Get to know your potential providers and know the person who will be directly responsible for ensuring the success of your revenue cycle management program. Will that person run, analyze and review reports with you on a regular basis? Are they or other customer service personnel available 24/7? What is their level of expertise in working with healthcare systems like yours?

Part of great customer service includes proper onboarding of the new system with current employees. Make sure your RCM vendor provides onsite training to help you transition to their services.

Discover the difference at ABILITY Network

When searching for the best revenue cycle management provider for your physician practice, hospital or health system, consider ABILITY Network. You’ll find we score at the top of every important criterion you need for a high-quality RCM process. We understand your goal is to maximize revenue and we have the processes and technology to help you do just that. Streamline your workflows, avoiding coding errors and reducing denials means you get paid faster. And when you expedite your cash flow, you’ll have more money in the bank. Improving efficiencies enables your organization to do what you do best — take care of patients. Call 888.895.2649 and let us throw our hat in the ring as your revenue cycle management software provider!

 

ABILITY and design® and ABILITY® are trademarks of ABILITY Network, Inc.

What is revenue cycle management in healthcare?

Revenue cycle management (RCM) in healthcare is the fiscal process that guides the identification, management and collection of payments for patient services. The process begins with patient pre-registration, is followed by claims submission, and concludes with remittance processing. We understand hospitals, physician practices and other healthcare operations want to prioritize their limited funds to improve facilities for patients and retain caring, skilled staff. Revenue cycle management in healthcare can help you do just that by streamlining and automating the process of receiving timely payments. The objective of RCM is to generate a system that helps you get paid the full amount for the care provided as quickly as possible. Successful implementation of your revenue cycle management is what pays the bills. Learn more about the healthcare revenue cycle and the seven basic steps your RCM process should focus on.

Step 1: Patient pre-registration

Your revenue cycle management process starts when the patient makes his or her appointment. To successfully collect patient payments, healthcare organizations must engage the patient throughout the process. The best way to start is during the first contact with your patient. You’ll establish the patient’s account and collect as much information as possible during this step, including payer information (insurance or other payers such as Medicare/Medicaid), and the medical history you’ll need later in the cycle. Next, you’ll distribute information to the appropriate doctors, nurses and administrative personnel to enable the best possible care.

Step 2: Pre-authorization

In the next step, staff will schedule visits and verify insurance eligibility. Confirming that the service is medically necessary according to the plan’s agreement (assuming it is not a medical emergency) will confirm benefits and help determine payment options. This process can be trying and time-consuming for healthcare staff. Often, organizations employ software that assists in checking patient eligibility electronically, which can expedite the process.

Step 3: Submitting claims

A claim is used by healthcare providers to submit and receive funds from insurance companies or other payers. A “clean claim” that gets reviewed and paid by a payer upon initial receipt expedites reimbursement and improves your cash flow. It’s very important that the physician records information accurately. Without accurately documenting the clinical service provided and attaching the correct code(s), the claim could be denied, or you could receive an incorrect reimbursement. Good software can submit claims electronically, helping to avoid human error.  It’s best if a charge capture system can interface with the electronic medical record (EMR) to optimize identification and capture of charges for more complete billing. You may also want to consider centralized charge standards across all departments to improve consistency. ABILITY Network has several RCM applications to help you streamline your claims management and billing and ensure compliance with CMS guidelines.

Step 4: Posting of the payment

Once you receive the insurance payment and it is posted to the account, you can submit the balance to the patient for payment. Once you have developed a relationship with the patient and gathered contact information, you should be able to use automation tools to send billing statements via mail and/or secure electronic data interchanges (EDI). You could also implement text message reminders. The easier you make it for patients to pay during this step, the faster you will receive payment.

Step 5: Managing and re-submitting denied claims

Tracking your denied claims is an important part of revenue cycle management in healthcare. Claims can be denied for various reasons, such as improper coding, missing items in the patient chart or incomplete patient accounts. Having a process to manage denials can help you recover revenue that might otherwise have remained overlooked because of insurance being filed incorrectly. Properly executed denial management will boost earnings if cash flow has been slow because of problematic claims. You might uncover denial patterns or trends, whether from human error or billing problems for certain types of procedures or members of your patient population. For anything that is not covered by insurance, healthcare organizations must notify and collect payments from the patient. It’s essential that providers help patients understand what they owe and why, identify primary or secondary insurance, consolidate bills, and be able to set up payment plans.

Step 6: Processing payments

Accounts receivable staff should verify all claims payments and process them as quickly as possible. The goal should always be to collect the maximum revenue in the shortest amount of time. You may need account specialists to help identify problem claims and to work with patients on collecting balances due.

Step 7: Financial reports

No automated RCM process is complete without the capability and processes needed to prepare valuable financial reports. Using custom software to develop the financial and management reports you need is key, along with reports on key performance indicators (KPIs) to track whether or not your team is meeting their defined goals.

Let ABILITY simplify your healthcare revenue cycle management

No doubt many medical practices, hospitals and other healthcare providers want to focus more on treating patients than ensuring the financial viability of their company. However, your revenue cycle management process is crucial to running your organization successfully. Without this key financial process, providers cannot keep their doors open to treat patients. That’s where ABILITY can help. We put systems in place to streamline claims management and billing, increase the flow of income, improve the care of your patients and reduce provider costs. Find out how we can help by reaching out via phone at 888.858.0506 or requesting an online quote. We look forward to helping you simplify and optimize your RCM process.

7 revenue cycle management best practices

We understand that your focus is (and should be) caring for your patients. But we also understand that patient care cannot happen without processes in place to ensure proper payment of expenses. With ever-changing healthcare regulations and new reimbursement models, it’s imperative for healthcare organizations to maintain a strong, stable revenue cycle management (RCM) process.

ABILITY Network has developed a variety of applications to help your staff save time and simplify complex tasks. Here are our seven best practices to help you develop and implement a successful RCM program.

1. Collect more information up front

Because the patient is such an increasingly important payer in today’s healthcare system, it’s crucial to collect all personal information available at the time a patient first seeks care — potentially even before they arrive for an appointment. Not only does this information provide the foundation for the claims you will process, but it will also dictate how you will collect payments from the patient or make payment arrangements for the balance due. Effective communication helps patients to understand their benefits and possible treatment alternatives.

2. Aggregate the data

As benefits and insurance regulations continue to change, it’s important to implement a revenue cycle management process that is able to aggregate all of the data throughout the cycle. It will provide benchmarks and analytics for key insights that can improve your process and your business success. Sometimes there is little you can do to increase your income and you may need to look at the expense side of the business. Easy-to-read financial reports can help management and staff to better understand expenses, ways to reduce costs and maximize revenue where possible.

3. Consolidate revenue cycle management to a single provider

Some healthcare organizations use multiple vendors for different revenue cycle functions, requiring extra time and resources to manage it all. Instead, consider consolidating your revenue cycle management operations to a single provider who can provide eligibility verification, claims management and patient payment processing. A single, comprehensive system streamlines workflows, increases staff efficiency and simplifies the billing process for patients, which can help them better understand and meet their obligations.

4. Collect patient payments at or before the point of service

This is one of the most difficult parts of revenue cycle management, but also one of the most critical. Collecting patient payments — as much as you can, as soon as you can — is important in keeping your organization’s money flowing. Determining Medicaid and Medicare eligibility and helping patients understand their coverage options is key. This is made easier by developing a relationship with patients and educating them on the insurance process, so they understand their financial responsibility ahead of time. As medical deductibles increase, more patients are having to pay more and may need to arrange financing or payment options prior to receiving non-emergency services.

5. Track claims throughout their lifecycle

Identifying the reasons for claims denials is as important as resolving them. Verifying insurance eligibility is the first step to ensure accurate billing. It’s also important to be able to track claims from submission to payment. Claims denials from Medicare and other payers should be recorded and analyzed to look for trends or common errors that can be corrected to stop the cycle of lost revenue.

 6. Implement staff development programs

One of the best ways to reduce denied claims is to ensure they are coded and processed correctly. As healthcare changes so quickly, it’s important for providers to develop and implement regular education programs for employees that teach proper coding techniques, comprehensive chart documentation and financial policy reminders. Besides reducing medical errors, training can also help reduce employee turnover.

7. Keep improving performance

 Even if your revenue cycle is functioning nicely, avoid the maintenance-mode mentality. Instead, keep pushing for optimum performance that maximizes your cash flow and net revenue. Use your data to find ways to earn a little more and to save a little more – perhaps by cutting costs, decreasing denials and reducing bad debt and underpayments.

Contact your revenue cycle management experts today

When you need assistance implementing best practices for your revenue cycle management process, reach out to the experts at ABILITY. We have powerful applications to develop and maintain positive revenue cycles within your physician practice, hospital or other healthcare organization — no matter the size. Request your free quote today and start maximizing your revenue.

How Telehealth Services Can Be Crucial to Your Revenue Cycle Management Strategy

We’ve been hearing it for weeks: Stay at home, social distance, avoid close contact with others, all in an effort to curb a global pandemic. The rules are a bit different for healthcare providers.

In addition to pandemic-related illness, people will continue to require medical care for a variety of reasons. As a provider, you’re challenged to protect your staff and your patients and still provide quality care.

Enter telehealth services.

With telehealth services, patients receive care (or a broad range of other services) from their providers without traveling to a healthcare facility. Even before the emergence of COVID-19, these services were gaining popularity from a convenience standpoint. In our current state, they have become an essential part of a provider’s revenue cycle management strategy.

Supporting your revenue cycle with empty waiting rooms

To help providers continue to care for their patients, the Centers for Medicare & Medicaid Services (CMS) has made allowances and broadened access for telehealth services.

  • Under the 1135 waiver, patient eligibility for telehealth services will no longer be limited by location
  • The originating site requirement is eliminated
  • Physicians, nurse practitioners, physician assistants and other limited license practitioners can provide services

Telehealth makes it possible for providers to operate and collect revenue without face-to-face office visits. Even HIPAA enforcement has been relaxed and penalties waived for providers operating in good faith.

Getting started with telehealth

Regulatory changes aside, you may wonder how to begin offering telehealth services through your practice. Questions about which platform to use, how to collect patient copays and how to capture the correct insurance ID (or MBI for Medicare beneficiaries) can seem overwhelming without the appropriate tools.

Once you decide which platforms to use, you’ll need to communicate this new option to your patients and ensure that your staff is knowledgeable on how to operate them.

To support an efficient workflow for your staff, ABILITY Network offers powerful applications for eligibility verification (including tools that return patient MBIs), Medicare claims management and patient payment collection, to keep your revenue cycle moving.

For the foreseeable future, telehealth services will be essential to keep your practice moving forward. Partnering with a single RCM provider like ABILITY can help simplify the journey.

To learn more about telehealth services, don’t miss this on-demand webinar presented by medical practice management expert Kem Tolliver.

3 Revenue Cycle Management Mistakes that Drain Revenue

Healthcare organizations have various metrics that help define and measure success. With so many moving parts, how do you determine what to prioritize?

A strong and efficient revenue cycle is the cornerstone of your organization, so it’s important to start there. It is responsible for paying salaries, buying new equipment and even keeping the lights on.

Are you making the most of your revenue opportunities? Below are three common mistakes that compromise cash flow, and what you can do now to correct them.

  1. Failing to verify eligibility before providing care

Ideally, providers would prefer to verify eligibility for every patient before they receive care. In the real world, this isn’t always possible. Many things can prevent prior authorizations, ranging from unforeseen emergencies to a busy day in the front office that simply doesn’t allow the time.

While you can’t eliminate emergencies, there are ways to cut down on the mountains of paperwork facing your office staff. How many administrative tasks are performed manually? And of those that are electronic, how many different screens do they have to log into to confirm eligibility for just one patient?

Electronic claims management saves a substantial amount of time by enabling batch inquiries and alerts to indicate additional coverage for Medicare beneficiaries. You can verify eligibility for more patients in less time without rejected claims headaches after the fact.

  1. Operating with a fragmented claims management workflow

Speaking of claims, is there anything that requires more time and attention than managing multiple claims with multiple payers? From unique business rules to confusing rejection codes, claims management is usually fraught with long A/R cycles and time lost trying to locate and manage missing claims.

Make your claims submission process more efficient from start to finish with ABILITY EASE® All Payer. With a single platform, you can manage CMS and all other commercial payer claims, verify claims against the most current business rules (as well as customize unique rules for specific payers), and even address eligibility issues up front, prior to claim submission. Most importantly, you can achieve acceptance rates of up to 98 percent.

When rejections do happen, the claim immediately returns to your work queue with a clear message about the correction needed. No more trying to decipher confusing codes while your A/R days pile up.

  1. Writing off denied, low-value claims

In the hustle and bustle of a busy workday, it’s not surprising that low-value, rejected claims become the lowest priority. Billers are stretched thin and their time is better spent working on new, possibly higher-value, claims. But it shouldn’t come down to one or the other. Using the right technology, your staff can successfully handle all types and give a needed boost to a sluggish revenue cycle.

If you don’t find time to settle all of your claims, you aren’t collecting all the revenue you’ve earned. These “low-value” claims add up over time, so what seems like a reasonable write off could result in the loss of thousands of dollars. Not taking the time to resubmit these claims also contributes to poor A/R performance and patient frustration.

Some simple steps you can take to address this issue include:

  • Have staff verify coverage and eligibility prior to treatment
  • Use historical patient data to create new claims
  • Track claims from submittal through payment

The single best thing you can do to strengthen your revenue cycle is to prevent as many rejected claims as possible. This is where electronic claims management systems can have a huge impact.

How to Keep Claims Denials from Affecting Your Revenue Cycle

Claims denials happen throughout the revenue cycle, but often their origins are at the very beginning, the moment a patient seeks treatment.

What’s driving the denials?

According to the Journal of Healthcare Information Management, 86 percent of healthcare industry mistakes are administrative[i]. It’s not surprising when you consider the volume of paperwork faced by front-office staff, and what in many organizations is still a heavily manual workflow.

The Technology CEO Council found that patient charts cannot be found on 30 percent of patient visits[ii]. Without this vital information, basic patient data and benefit eligibility information are missing, leading to claims mistakes and denials.

Unfortunately, eligibility questions aren’t the only problem. In order for claims to be accepted and paid promptly, they must legible, accurate and complete – a tall order considering the number and complexity of diagnostic codes and the pace of regulatory changes.

Denials cost more than you think.

Trying to recover lost revenue can be a lengthy and expensive process, but worth the effort for providers. In the second quarter of 2016, the average automated claim denial from Medicare’s Recovery Audit Program was worth $714. And complex denials that required medical record review averaged $5,418[iii], according to the American Hospital Association.

With so much at stake, preventing mistakes from happening in the first place and avoiding denied claims is the best approach. But how? First, identify the real reason claims are denied:

People make mistakes.

We are human, and sometimes we make mistakes, no matter how good we are at our jobs, or how great we are as people. When you mix our humanity with a very complex healthcare system that is constantly changing — it’s no wonder errors happen. But it doesn’t excuse us from seeking a better way to complete this process.

It’s an easy fix.

Here’s the good news: most revenue lost along the revenue cycle is preventable through automation. And the majority of claims that are denied don’t have to be.

An automated system with a built-in claims scrubber, custom business rules and pre-submission eligibility checks can help ensure the cleanest claims possible. It can also keep up with current diagnostic codes so your staff doesn’t have to.

Imagine having a first-pass acceptance rate of 98 percent. It’s possible with ABILITY EASE® All-Payer, a software application that also helps eliminate the administrative burden of submitting secondary claims.

When it comes to revenue cycle management, it really pays to do it right the first time. Advanced technology makes it possible.

 

[i] Journal of Healthcare Information Management, Volume 17, Number 1, Winter 2003, https://www.himss.org/jhim/archive/volume-17-number-1-2003.

[ii] Technology CEO Council, A Healthy System Report, 2006, http://www.techceocouncil.org/clientuploads/reports/A_Healthy_System_Final.pdf.

[iii] Jacqueline LaPointe, Hospitals Still Facing Medicare Claims Denial Management Issues, October 17, 2016, https://revcycleintelligence.com/news/hospitals-still-facing-medicare-claims-denial-management-issues.

Three Revenue Cycle Management Tips to Simplify Your Medicare Claims

Revenue cycle management should be a priority throughout the patient’s journey — from the moment a patient walks in to receive healthcare services, to the moment that patient pays their final bill. There are many opportunities along this journey for healthcare providers to make their revenue cycle more efficient and productive.

These “big-picture” tools help along the way: clear communication, top-notch staff training, superior organization and state-of-the-art technology. But this high-level, simplistic view of revenue cycle management just scratches the surface when it comes to Medicare claims.

When your revenue cycle management journey includes Medicare, you’ll often experience detours, obstacles, errors, stalls and redirects. (And sometimes you have to do it all over again.)

The job of advanced technology is to make this journey as smooth as possible. Simply put, technology’s main goal is to improve revenue cycle management. This includes such things as: eliminating redundancies, reducing or removing human error, easing frustration and getting that final bill paid quickly and correctly.

What are the best ways to get your Medicare claims to the finish line? Are there ways to save time and money along the way? Here are three tips to help simplify Medicare claims:

Tip #1 Use your time wisely.

It seems like every week there is a new rule or regulation from CMS. Keeping up with these changes is a job in itself. When preparing documentation for Medicare claims, who has time to do anything more than once?

CMS continues to toughen its claims scrutiny, and organizations could see an increase in post-payment reviews. Plus, changing payment models are boosting the number of denials and the need for appeals.

Your time is important. Automate your most time-consuming processes: submission and tracking of ADR responses, RAC audit information and appeals. 

Tip #2 Pass on paper.

These days, stationery stores have all but disappeared, but the healthcare industry still loves (and uses a lot of) paper. Did you know 50 percent of healthcare claims are filed are on paper? This can result in errors and wasted time.

Paper wastes a lot of money, too. A recent CAQH Index® report shows a staggering $8.5 billion is being wasted on medical providers’ manual transactions.

Reduce your overhead and save time by eliminating paper, printing and mailing costs. Instead, submit your Medicare documentation using secure, HIPAA-compliant electronic delivery.

Tip #3 Let technology do the heavy lifting.

Technology plays a critical role in successful claims management. It can streamline your process for secure submission, tracking, and reporting for Medicare claim review programs, and even help ensure proper reimbursement.

Medicare claims offer unique challenges that only the most adaptable, comprehensive and robust application can handle. Applications like ABILITY AUTOMATETM esMD manage Medicare claims and make the process a whole lot simpler for you.

5 Simple, Yet Effective Ways to Decrease Billing Mistakes

Billing mistakes can cost your organization a lot of revenue. From increased days in A/R to claims rejections, you may be surprised at just how much money you’re leaving on the table. Fortunately, though, you can accelerate A/R days, reduce rejections and greatly increase your clean claims rate with just a few simple, yet highly effective strategies.

Always verify patient information and insurance benefits

First, whether you’re handling billing for a patient for the first time or you’ve been treating them for years, you should always verify their information and their insurance benefits up front. A patient may have moved, changed jobs or their benefits may have changed. These changes can easily result in rejections or denials and delay payment.

Significantly reduce billing mistakes by taking the time to double-check patient information and insurance coverage before submitting a claim.

Eliminate repetitive tasks

You may be wondering where you’ll find the time to verify every patient’s information. Fortunately, those verifications don’t have to add extra work when you can put technology to work for you. This next tip will help you save a lot of time while you say goodbye to even more billing mistakes.

With the right application, such as ABILITY EASE® All-Payer, you can eliminate repetitive tasks. For example, this application gives you the power to perform batch eligibility checks and run multiple payers and patients in a single session. So, you can ensure that you’ve verified patients’ benefits information while also significantly decreasing the burden on your billing staff.

Check against the most up-to-date rules

Checking against out-of-date rules will inevitably lead to more claims rejections and denials. Unfortunately, those rules can change on a quarterly, weekly or even daily basis. Your claims management tools should update in real time to ensure that you have visibility into the latest rules. With more clean claims, you’ll see a reduction in billing mistakes and decreased days in A/R.

Address potential eligibility issues up front

If you aren’t sure if a patient — or group of patients — is eligible for certain benefits or coverage, you leave yourself open to claims rejections. Your staff has to deal with the hassle of tracking down those claims and trying to determine what was wrong.

Claims management tools should easily integrate with eligibility verifications to allow you to catch mistakes early, before the claims go out. This saves an enormous amount of time and will likely result in an increased clean claims rate and more revenue coming back to your organization.

Use the right tools for faster correction guidance

When billing mistakes do happen, you can decrease their impact with an application that gives you fast correction guidance. Gone are the days of manually finding the reason for rejections, and then submitting appeals or contacting payers individually. An automated application can route that claim right back to your work queue with a clear message about the corrections needed.

The first step to optimizing your revenue cycle is to correct billing mistakes before they cause revenue problems.

For more tips to streamline your billing processes, visit the billing and claims management page on the ABILITY resource center.

revenue cycle management

How to Decrease Your Rate of Rejected Claims

Imagine if you went into a patient visit knowing that you wouldn’t receive payment for your work. Would you invest as much time on that patient? Would you hope to see their name on your schedule again?

Compare this scenario with one in which you know for a fact that you’ll receive payment. Most healthcare professionals would choose the latter. However, many hospitals and facilities receive payment rejections on a regular basis. As much as you want to provide every single patient with the best possible treatment, you also need to make sure you’re collecting all the projected revenue associated with your work.

If you’ve been seeing a spike in rejected payments, it’s time to reassess your revenue cycle management efforts. Try using these five tips to help prevent rejected payments.

1. Clean up your documentation and coding process

In a recent HIMSS Media survey, 41 percent of respondents said clinical documentation and coding is a high-risk area for losing revenue, and 43 percent of respondents considered it a medium-risk area.

If you agree, put a stronger emphasis on correct coding. Invest in employee training to ensure that everyone understands the codes your team is working with. Or, try scheduling more people per shift so your team isn’t spread thin and is less likely to make mistakes.

These are just a few ways to improve coding efficiency. If coding errors are affecting your organization, you can’t afford to overlook this issue any longer.

2. Send claims in batches rather than one by one

Sometimes, payment rejections occur because a claim has been submitted to the wrong payer. Additional reasons for rejections include:

  • Inaccurate or missing patient information
  • Inaccurate payer information
  • Terminated coverage
  • Timely filing deadlines
  • No referral on file (for applicable services)

Batches can’t solve all these issues, but they can offset the chances of payment rejections. Working in batches means you can group claims by payer. It reduces the risk of sending claims to the wrong payer and helps you file claims in a timely manner.

Thanks to the digital systems that make working in batches possible, you’re also able to prevent inaccurate or missing patient information as you work through each claim in your batch. Think of your eligibility and claims management system as your second set of eyes. It will tell you if there’s any adjustments you need to make in any claim within a batch. When you have no notifications, you can trust that every claim has all the information it needs to be accepted.

3. Consolidate your claims management

Speaking of eligibility and claims management systems, how many different revenue cycle management tools do you use? Do you have one filing process for Medicare and Medicaid payers, plus a separate way of submitting claims to private payers?

This kind of workflow only increases your risk of rejected payments. On the other hand, using a single portal like ABILITY EASE® All-Payer to communicate with payers makes your RCM more efficient. It increases the accuracy of each claim you make, and helps you catch any mistakes before a claim is submitted.

The result? A faster, cleaner claims management workflow.

4. Track your audits and appeals

Although automated tools can significantly increase claims efficiency, they can’t guarantee first-time acceptances for every single claim. Make sure to track your audits and appeals whenever you find yourself resubmitting claims.

This provides full visibility on all your outstanding payments. It allows you to track financial performance metrics and hold your team accountable to the goals you’ve established. It can also help you adjust your financial strategy if necessary.

5. Save patient data

The final tip to help you decrease rejected payments is to save patient data. This will significantly improve the accuracy of every claim you create, in addition to speeding up eligibility verifications and claims submissions.

Note, this doesn’t mean you should keep storing paper files for all your patients. The better option is to save patient data within your claims management portal. This way, all you have to do to create a new claim is click a few buttons. You can quickly pull the information you need and trust it’s accurate, rather than waste time sifting through piles of paperwork and double-checking everything manually.

There’s no reason to keep letting rejected payments add up, or to spend hours on revenue cycle management. Start using tips above to improve your chances of receiving full payment with a faster, more accurate workflow.

patient satisfaction

The Impact of Patient Satisfaction on Your Revenue Cycle

The value you offer patients has a direct effect on the revenue you collect. This applies to all healthcare organizations, but unfortunately, not all providers understand the impact patient satisfaction can have. The more satisfied your patients are, the better your revenue cycle management performance will be, which affects many other aspects of your business.

Here’s a closer look at how patient satisfaction contributes to financial growth (and losses).

The high costs of low patient satisfaction

Patients want clear pricing and payment expectations. They also want:

  • A deep understanding of their condition
  • Actionable steps they can take to improve their health
  • Simple, stress-free payment processes
  • The option to manage high treatment costs with a payment plan

All these things show patients that they’re genuinely cared for. When providers offer such resources and payment options, patient satisfaction increases. When these aren’t included in treatment, patients are likely to be dissatisfied.

And when satisfaction is low, many aspects of your organization are hindered – including financial performance, market share, and care quality. Dissatisfied patients are less likely to pay their medical bills in full, if at all. There’s very little chance these people return for more services, which is how market share can suffer. Even patients who continue treatment may not be fully engaged, resulting in a decrease in quality care levels as patients stop adhering to their treatment plans.

Luckily, these issues can be avoided by investing more in your patients. There are plenty of ways to increase patient satisfaction while also improving revenue cycle management performance, care quality and much more.

The revenue cycle management benefits of investing more in patients

Providing a more satisfactory patient experience can be as simple as taking the time to explain payment responsibilities or as significant as implementing new tools and processes. Convenient payment technology or an advanced claims management system can help you better serve your patients, your staff and your bottom line.

The following is a closer look at three of the top ways to increase patient satisfaction with improvements to revenue cycle management.

1.     Help patients pay faster – and in full

Price and payments are some of the biggest factors that affect patient satisfaction. While you may not be able to lower your costs, you can make patient payments more accessible and easier to manage with a tool like ABILITY SECUREPAY™.

This allows patients to conveniently pay their fees anywhere, anytime. Patients with ongoing treatment can set up automatic payments and those who see you for one-time services have the choice to pay with a credit or debit card in addition to cash and checks.

These payment practices are very familiar to your patients; they’re tools patients use every day in other aspects of their lives. When patients have the option to pay for medical bills in the same manner, they’re more likely to pay quickly and in full, increasing patient satisfaction and practice revenue.

2.     Decrease billing mistakes

Billing mistakes don’t benefit anyone involved in treatment, yet for most organizations, they’re a common occurrence. These issues slow down your revenue cycle and can lead to lost profits. They’re also a stressor for patients.

If it’s become the norm to see your staff discussing billing mistakes with patients, it’s time to try a new approach. Implement an eligibility and claims management process that creates a satisfactory experience for all. Make it easy for billers to input patient information and track claims. Eliminate the need for your staff to sift through paperwork and the risk that patients’ bills go unpaid by their payers.

This will result in higher patient satisfaction and engagement, a more motivated staff and a healthier revenue cycle.

3.     Prepare for price shopping

One-third of healthcare consumers used the internet or mobile apps during the past year to compare the quality and cost of medical services. They price shopped before seeking treatment, a trend that will continue to rise in the coming years.

Providers need to prepare for this now by improving pricing transparency, strengthening their organization’s brand and increasing patient satisfaction. They need to put a bigger emphasis on value-based care and comprehensive treatment.

These are the details potential patients look for when comparing provider reviews. They keep current patients coming back and new patients coming in to begin treatment. Thinking long-term, an early adjustment to price shopping can mean significant rewards for your organization.

At the end of the day, all the functions of your organization should be rooted in one purpose: serving your patients. If you fail to meet their expectations, revenue performance will be one of the first things to feel the consequences. However, put the above tips to work to make sure your organization is performing well across the board and watch how patient satisfaction skyrockets – and how your entire organization benefits.