January 29, 2016
The healthcare industry is plagued by financial constraints, and most of the industry leaders quote the Affordable Care Act while talking about their financial difficulties. The real culprits however are the revenue cycle processes that are more than outdated. More often than not, it takes a major revenue-negative incident that triggers a spurt of hectic activity. Not conforming to the fee schedules and payer rules that keep changing frequently is another reason cited.
When it comes to transportation of patients, the ambulance companies play the crucial role of saving lives, and the all-important collection process, which is part of the revenue management process is given just a casual afterthought. Ambulance companies need to pay serious attention to revenue cycle management and deal with real-time issues affecting revenue with an analytical mind. The ambulance transportation finances of these companies need to adopt usage of new tools and other efficient training practices that help track claim data. It would also do them good to focus on timely claim submissions with zero error.
Have a revenue cycle management (RCM) team that is trained to create and furnish customizable reports that helps you have an insight into the important financial metrics in the organization. The team will also be responsible for maintaining fee schedules and keep customers updated. This helps in optimizing the clinical workflow, ensuring excellent financial performance. The team also needs to be updated on best practices that need to be followed in collections and billing.
Claims management needs to be proactive by reaching out to payers, checking on their claims and tracking all changes in payer reimbursement. This insight needs to be shared with practices so that they can realize improvement in their net collection ratios, which need to be healthy at all times. The days in accounts receivable need to be reduced to a viable level, with a marked increase being shown in reimbursement.
Ambulance companies need to focus on collection of unpaid bills so that they achieve break-even in their operations. The operating expenses need to be covered from bill collections and not by infusing fresh funds whenever there is any shortage. With regulators and health insurers insisting that practices keep tab of patient experiences and report them promptly, ambulance transportation companies need to focus on patient engagement and satisfaction. The security requirements, deadlines on programs and persistent regulatory hurdles in various aspects of healthcare need to be dealt with effectively.
Ultimately, it is up to the practices to ensure that improvement in ambulance transportation finances is achieved through efficient revenue cycle management. There should be no lag in follow up on A/R or insurance coordination that leaves much to be desired. Every member in the team needs to be well trained so that he or she fits into the role perfectly, thus contributing to the revenue cycle. Due diligence needs to be paid while coding and dealing with collections. Inaccuracies in coding can leave the practice losing several thousand dollars in a year. Errors in data entry need to be avoided, and automating billing helps save every crucial dollar.
Revenue Cycle Management