The healthcare sector in the United States has a huge infrastructure that is required to maintain every aspect of patient treatment. With the cost of operations go up by the day, medical facilities have gradually started to offshore various sectors to other dedicated companies like Revenue cycle management specialists, who are solely focused on providing medical billing services.
Revenue cycle management is the contemporary aspect that is under discussion to be outsourced or is now being outsourced due to various reasons, but mainly due to the financial viability it provides to the doctor’s office. In some cases, it is permanently contracted to the experts in the fields, which lets the in-house staff and the doctor provide more time to patients.
There are many characteristics of the revenue cycle management, and they all need to work in a coordinated way so that the leaks in the system are managed. The first concern of the hospitals was the restructuring or implementation of a whole new revenue cycle management system.
Nevertheless, its feasibility for many healthcare units was not possible, as it required a lot of investment in staffing and other internal requirements. Then came the option to offshore this process, which felt like the next most suitable option, that physician could opt for.
Here are some common challenges healthcare units face when working to improve the revenue cycle, and tip to overcome them.
Lack of modern tools
Patients have started to demand the cost of care estimates simply because they receive them in other areas of their life. As patients are being asked to pay more for their healthcare, they are demanding this same level of transparency from the doctor’s office as well, that they expect from other consumer transactions.
Providing estimates boosts patient satisfaction and in-turn the revenue cycle growth as people appreciate the increased insight into the total expense. By committing to using modern RCM related tools hospitals can seize the opportunity to better communicate with patients and set suitable expectations, resulting in complete reimbursement.
Your staffs are offloaded to take over other duties
With patient payment making up almost a third of revenue, medical billing service providers are realizing that they cannot wait until patient checkout to communicate with them about what they owe. In such a scenario many proactive organizations are shifting workloads from the front end to dedicated specialty medical billers and coders.
Initially, this move may cause some concern because organizations might worry about staffing constraints. Fortunately, they can address the staffing issue by reallocating back-end staff to the front end, keeping in mind that the ideal staff ratio ranges. In many cases, as facilities start using technology that helps automate both fronts- and back-end processes, with it they will be able to accommodate more work across their existing staff.
Take care of the patient data
While common, not every healthcare facility has issues with reimbursements, but they struggle with other aspects of the payment, which is medical billing and coding. It is important for healthcare establishments to have a solid understanding of their strengths and weaknesses so as to focus on those areas that are in greatest need of improvement.
The best way to attain this knowledge is to leverage data analytics that focuses on performance in specific areas and pinpoint opportunities. For instance, by using analytics that includes the net collections rate, a medical facility can determine the ROI of cost estimation technology and get a better understanding of potential benefits.
Similarly, data management can clarify staff utilization, so an organization can identify the best ways to reallocate resources. In the end, financial analytics of your RCM can provide a sense of how and when you get reimbursed, so you know what tools to implement to increase convenience and speed of payment.
FAQs
1. What is Revenue Cycle Management (RCM) in healthcare?
RCM refers to the financial process that healthcare facilities use to track patient care from appointment scheduling to final payment. It includes medical billing, coding, and reimbursement processes to ensure timely payments.
2. Why are healthcare facilities outsourcing RCM services?
Outsourcing RCM services helps reduce operational costs and allows doctors and staff to focus on patient care. It also ensures that experts handle complex billing tasks more efficiently.
3. What are the main challenges in improving the revenue cycle?
Common challenges include a lack of modern tools for cost transparency, staffing issues, and inefficient data management. These can lead to delays in reimbursements and increased administrative burdens.
4. How does technology help improve the revenue cycle in healthcare?
Using modern tools, such as cost estimation software and automation, improves patient communication and speeds up billing and coding processes. It also helps healthcare providers manage their staff more effectively.
5. How can data analytics improve the revenue cycle management process?
Data analytics can identify areas needing improvement, such as billing errors or slow reimbursements, and provide insights on resource allocation. This helps optimize RCM performance and boosts financial health.