Revenue Cycle Strategies that Every Practice should adopt

November 06, 2014

Managing the revenue cycle performance in a competitive healthcare environment involves risks as well as opportunities. Factors like increasing patient responsibilities, payment model changes and stringent regulations have made revenue cycle management challenging for providers.

Quick Facts:

The market revenue for physicians RCM applications and services is expected to grow by 21.6% in the coming years. It will reach $14.6 billion by 2016
Around 25% of medical practices income is lost due to missing charges, under-coding and underpricing
Coding errors, data entry errors and complexities of claims result in majority of the rejections and underpayments

In order to overcome these challenges, practices need to adopt the following revenue cycle strategies:

  1. Enhanced documentation - Improving clinical documentation can be an important survival tactic for hospitals as well as private practices. Documentation skills are not taught to doctors or the healthcare providers in medical schools. Hospitals and healthcare systems compensate this lack of training by conducting educational programs and implementing tools that align providers with the documentation practices. Physicians are required to invest significant time and money in allocating resources for Clinical Documentation Improvement (CDI) training and development
  2. Identifying RCM bottlenecks - It becomes essential to identify the loopholes in the revenue cycle in order to maximize reimbursements. Physicians remain frustrated with the increasing number of administrative hassles. They have to face reimbursement complexities that are mainly caused by the need to comply with various requirements from the government and commercial payers. It is important to educate the staff about their role within the revenue cycle and how it will impact the bottom line of the practice. Physicians need to keep a tab on the financial status of the practice and take necessary measures to establish workflow consistency. Many practices have started outsourcing their revenue cycle management (RCM) needs to billing companies like MedicalBillersandCoders.com. MBC is one of the reputed billing companies, offering effective revenue cycle solutions to physicians across all the 50 states in the US
  3. Enhance front-end processes - The healthcare sector is expanding and becoming consumer-oriented. This has pushed the need to improve front-end processes along with RCM. It is no longer sufficient to manage a patient’s payments from the existing back-end model. The front-end processes need to be improved because the complexities and unpredictability of payment is growing in the US healthcare industry. Practices need to hire skilled front-end staff that can help in getting patients registered directly. Processes will have to be changed to make sure that payment obligations or deductibles are easily identified when appointments are booked rather than chasing the patient for payment after they have received the medical billing services
  4. Implement tools to increase patient engagement - Necessary tools should be implemented to enhance patient engagement and increase revenue. Practices need a comprehensive patient engagement framework as it will help them improve the patient experience, meet the rising patient demands for better access to care, meet the requirements for Meaningful Use (MU) Stage 2, adapt to new care models easily and implement new health insurance structures to serve consumers in a better manner. Right technology and services will have to be implemented in order to improve patient engagement because it is directly related to revenue generation

In case your medical practice is suffering losses or has constraints in capital investment for implementing any of the above then outsourcing is meant for you. Trust MBC as your medical billing partner and increase your collections like never before.


Category : Revenue Cycle Management