Here are four revenue cycle management tips from industry experts, published by Becker's Hospital Review on or after March 27.
1. "When not managed properly it's easy to lose control over the number of tax IDs your providers have; this is especially true for large hospitals with hundreds of providers. A good rule of thumb is no more than three tax IDs per provider. While downsizing these numbers is a cumbersome task that requires diligent follow-through, an outsourced partner with proven knowledge and resources can make a world of difference in regaining control." - Patrick Doyle, senior vice president at Newport Credentialing Solutions
2. "Outreach labs are too often overlooked by hospital leadership and considered a cost center due to a lack of visibility and understanding of key performance indicators. Many outreach labs are using hospital revenue cycle management systems and other medical billing products that not only lack the lab-specific configurability and connectivity to maximize reimbursements, but also do not have the reporting tools needed to truly understand business performance. To optimize financial performance and demonstrate business value to hospital leadership, track lab-specific KPIs such as net revenue and operating margin on down to detailed analysis of month-over-month revenue and profitability by client, test and payer." - Mike Fauver, associate vice president of health systems at Xifin
3. "Providers need to understand that each communication related to claims management — either directly or indirectly — has the potential to impact the revenue cycle. For example, certain payers will send regulatory notices and edit change notifications as a cover letter to a paper remittance. Since remittances are sent directly to an accounts receivable clerk, patient access and billing departments often miss important information included on the cover letter about the rule changes. It is important to also know where all communications are coming into your organization, and who receives and/or manages them. Managing payer correspondence is especially problematic for organizations that manage their claims and eligibility manually or use disparate systems.
"Once you've identified the communications coming in and who handles them within the organization, you need to ensure that the right communication reaches the right person in a timely way. While some organizations struggle with manual processes around this, technology can help with managing claims-related communications, ensuring the information reaches the right people efficiently. RCM workflow software that effectively tracks and manages claims communication can help ensure you are acting on the most timely and correct information to optimize your revenue cycle. RCM software can help reduce the manual and cumbersome job of passing information between departments, and avoid the gaps and misses that come from this information flowing through people versus processes, and most importantly, it helps reduce errors and omissions that can slow your revenue cycle down or increase denials." - John Carter, senior vice president of revenue cycle management at Ability Network
4. "Don't let your analytics solution become shelfware. Over the past several years, there have been myriad analytics solutions available in the RCM marketplace. While these solutions offer promise, it's not a given that each has the ability to deliver on improving operations at your organization. Optimizing resources, improving revenue and managing costs require analysis of vast amounts of operational data. To accomplish this, the ideal analytics solution is one that uses native operational data versus aggregated data.
"Analytics goes hand in glove with operational improvements when one considers the multivariate analysis required to understand root cause across the organization. Of importance when considering improvement is granularity of information and the ability to leverage data from native sources. Analytics helps organizations understand the levers they can pull to effect change to a process and measure the impact of that change." - Eric Nilsson, chief technology officer of SSI Group
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