An efficient hospital revenue cycle process relies on all administrative and clinical functions working together, but with so many moving parts, there is always room for improvement.
Healthcare leaders shared with Becker's Hospital Review one thing they would do to improve the revenue cycle process.
1. Mark Norby, chair of revenue cycle at Rochester, Minn.-based Mayo Clinic, said that "creating a data-driven process would help meet the operational challenge of increasing precertification and prior authorization requirements by private or government payers."
2. Yvonne Robinett, revenue cycle director at Gillette, Wyo.-based Campbell County Health, stressed the importance of timely documentation from providers for care rendered. "Whether [it's from] nurses, providers [or] midlevel providers, getting that documentation in a timely fashion is probably one of our big pain points right now."
3. Brad Tinnermon, vice president of revenue cycle management and revenue integrity for Phoenix-based Banner Health, discussed documentation coding and clinical documentation improvement. "We're seeing a lot of opportunity in that area, but also a lot of pressure from pay-for-performance and health quality grades, where our health systems are more heavily scrutinized on the outcomes and quality of service we provide," he said.
"Obviously, there's been movement to all patient-refined diagnosis-related groups, from Medicare severity diagnosis-related groups that are getting more specific in making sure teams are really in lock step, to accurately document the care provided and tie that accurately to the outcome. So that's an area we're looking to innovate in."
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