The healthcare revenue cycle management service is the backbone of every healthcare setting. It is a process that constitutes tracking and analyzing the revenues generated by the patients during the entire course of care receiving. The cycle starts right when the first appointment is booked and ends when the cost of patient care is paid.
A revenue cycle management service’s ultimate goal for healthcare is to generate the most revenue. Hence, the healthcare revenue cycle also considers multiple factors along with the cost of care charged by the facility.
Revenue cycle management is a very complex process, and when it comes to healthcare settings, it becomes even more difficult. That is where healthcare revenue cycle management service comes in. To get a better understanding of the revenue cycle, here is a deeper insight into its steps of it:
Steps Of Healthcare Revenue Cycle Management
The healthcare revenue cycle management services consist of three steps:
- Registration: Revenue cycle management begins when a patient schedules the first appointment. The care facility employees gather all the required information to treat and generate bills. The report includes the patient’s name, contact information, address, insurance and medical records. The care provider employees must ensure that the data collected is correct and latest.
- Medical Coding: In this step, the healthcare setting uses standardized coding methods for the medical procedures provided to the patients. Every medical practice is assigned a medical code, and this step is crucial and requires accuracy to avoid any administrative interruption.
- Medical Billing: The last step of healthcare revenue cycle management is the final bill payment. A medical billing professional reviews the coder’s work and ensures that the bill received is accurate. This is also important to prevent the bill from getting rejected by the insurance company and ensure the smooth flow of the
Roles And Responsibilities Of The Healthcare Revenue Cycle:
Revenue cycle management is based on more than hospitals’ healthcare services. This whole healthcare revenue cycle mainly involves one question that most patients ask, “How much will I pay for my care?”. This process also looks for ways to execute a patient-centric point of view on financial communications and commitments.
The Healthcare revenue cycle has the following roles and responsibilities, and revenue cycle teams center their efforts on:
Now, people ask about healthcare prices, and their questions center on the total cost of healthcare facilities. Healthcare teams talk with patients and make them understand the total price and cost of the care they receive. These teams tell the patients about what is included in this price and how much cost their insurance will cover.
Equitable Access To Care:
The revenue staff aids patients who want to apply for financial assistance whenever they need it. These teams also make and establish payment plans that meet patients’ requirements. This financial assistance should be according to hospital policy.
Conversation with Patients:
The revenue team educates patients about the overall cost of the healthcare they are receiving at the hospital. They also tell patients about their insurance coverage and the responsibilities of the individual. The revenue team tries to understand any individual’s financial circumstances and suggest the best way for the patients to carry on their healthcare costs.
How Can You Succeed At Healthcare Revenue Cycle Management Services?
Healthcare organizations largely rely on revenue cycle management services for their profit and success. Hence, staying on top of the game is very important. Here are a few strategies on how you can succeed in healthcare revenue management:
Prioritize Front-End Tasks:
To succeed in revenue cycle management, front-end tasks like patient access and front-end optimization must be prioritized. Why? Because they help in moving claims and errors that mostly occur at this stage and are likely to disrupt reimbursement of claims. In addition to these two, insurance eligibility verification is equally important.
The most common errors in the front-end tasks are eligibility verification followed by registration and authorization, which lead to claim denials.
One of the top strategies to succeed at revenue cycle management services is to digitalize the front-end workflows. This strategy was employed by many healthcare settings during the covid-19 pandemic and has been quite popular across the globe. For example, contactless registration proved to be quite convenient for patients and employers and eliminated errors. Remember, claims are easily deniable; for instance, a missed signature or an incorrect code can lead to claim denial and a clinical or technical problem. So, you must be extra careful during the process, especially the front-end tasks.
Automation is a very effective way to reduce claim denials. For your revenue management to run smoothly, you must train your staff in coding and billing processes, educate them about medical costs and invest in software designed for coding automation and verification of insurance.
Normally, there is lots of stuff on the plate for healthcare management. Hence, outsourcing to a third party effectively balances financing with top-notch patient care. But before you select a healthcare revenue management service, do your complete research, as outsourcing might lead to higher rates of claim denials for some healthcare settings.
Delayed reimbursements disrupt the provision of quality healthcare, a nightmare for every healthcare setting. Therefore having a healthcare management service is very important and quite the need of the hour. It helps generate enough revenue and helps healthcare providers focus solely on providing the best healthcare service to their patients. Make sure you hire the best in the game to succeed in revenue management.