Hospitals' profitability increasingly depends upon enhancing and diversifying revenue cycle technologies to juggle different types of payment models.
Below are five indicators a hospital's revenue cycle software may need updating, according to biometric identification provider RightPatient.
1. Lack of business intelligence reporting and analytics capabilities. BI reporting empowers administrators to understand cash flow on a macro and micro level without relying on external consultants. Using the same interface, hospital leaders can pull up metrics on overall hospital profitability or zoom in to focus on a particular service. Easily accessing financial information in a self-service manner can shorten administrators decision-making processes, which could make hospitals more agile.
2. Unable to manage disparate specialties, departments. Revenue cycle management systems incapable of scaling to growing business needs or managing diversifying medical specialties will be less successful as hospitals juggle new payment models. As hospitals begin taking on greater numbers of risk-based or capitated contracts, administrators should consider investing in best-in-breed IT modules to enhance or supplement revenue cycle functions.
3. Fails to manage and facilitate the entire claims process. It's crucial RCM systems manage the claims process from beginning to end, giving employees a seamless way to administer claims processes and target pain points causing denials or delays. Integrated claims systems should alert staff to claims requiring follow up as well as outstanding reimbursement payments.
4. A hindrance to workflow. RCM systems should expedite hospital operations rather than hinder workflow. Systems that force employees to navigate outside of the system to complete eligibility, scheduling or verification processes impede efficiency, increase chances for error and complicate administrative tasks.
5. Cannot integrate with other systems. RCM systems capable of integrating with disparate IT systems can benefit hospitals by supporting inter-department collaboration and communication, which is a strategic priority for all hospitals under value-based or risk-based reimbursement models.