With cash flows declining, margins tightening and bad debt increasing, it's more important than ever for hospitals and healthcare providers to maintain a steady stream of income.
Revenue cycle management is the lifeblood of any practice, whether private or nonprofit, and provides the best measurement of an institution's financial wellbeing. From the first scheduled appointment to the final service bill, below are 10 thoughts on improving the collections process for providers.
1. Capture accurate patient information during registration. To quote Physicians Practice, "the revenue cycle starts with patient registration." Collecting correct patient demographics at the first point of contact lays the groundwork for an efficient, effective collections process.
2. Thorough eligibility checks. By overlooking potential care coverage during the pre-authorization process, providers may be inadvertently leaving revenue on the table while driving-up bad debt and charity care costs. A thorough eligibility and pre-authorization process ensures providers will receive the highest possible reimbursement from a patient's health plan while reducing a patient's financial burden.
3. Accurate price estimation. In an era of high-deductible plans, price estimation can be a critical precursor to patient collections. By increasing financial transparency and clarifying care costs up front, patients can establish viable payment plans and are better prepared to foot healthcare bills.
4. Point-of-service collections. "Collecting payment at or before the point-of-service reflects the industry's experience that as more time passes after care is delivered, a patient's propensity to pay decreases substantially," said Christopher Kerns, managing director of research and insights at The Advisory Board. By requesting payment before services rendered, point-of-service collections has the potential to substantially reduce uncompensated care and the resultant bad debt.
5. Educate staff about empathetic communication. Requesting payment at the time of service marks a cultural change for healthcare staff and patients alike. To ensure POS collections don't negatively impact patient experience, hospitals should train staff in empathetic communication strategies to aid patients through the financial shift.
6. Shift focus from denial management to denial avoidance. A high clean claims rate not only keeps cash flowing, it can save thousands of dollars per year in paperwork costs, time spent interacting with insurers and reworking claims.
7. Track key claims metrics. By keeping an eye on claims metrics, providers can spot inefficiencies and resolve problems quickly and efficiently. Monitoring data and establishing benchmarks for claim rejections, denials and days not final billed can offer critical insights into revenue cycle health.
8. Online payment options. Diversified, online billing services can facilitate better reimbursement rates by offering the most convenient method of payment for patients. Fiserv's Seventh Annual Billing Household Survey shows a strong relationship exists between customer satisfaction and the billing and payment experience.
9. Integrated RCM/EHR system. More health systems are choosing fully integrated RCM/EHR platforms to streamline and consolidate billing and collection processes. By integrating EHR and revenue cycle management systems in a clinically driven RCM model, provider organizations can realize tremendous gains in financial performance by optimizing revenue streams directly at the point of care, maximizing and speeding reimbursement, minimizing denials and streamlining the collection process
10. Service-to-payment velocity. Understanding the amount of time spent at each step of the claims cycle is critical to making timely adjustments and improvements to keep cash moving.