An efficient hospital revenue cycle relies on administrative and clinical functions working together, but with so many moving parts, there is always room for improvement.
Here, healthcare leaders shared how they would improve the revenue cycle with Becker's Hospital Review:
1. Melissa Shore, vice president of revenue performance management at Boston-based Dana-Farber Cancer Institute: "I think if we could leverage technology better, that would be extremely helpful. There are so many manual workflows, and many of them are routine. If we could carve out the routine tasks for a machine and let people focus on analyzing and problem-solving, I think we would be working smarter instead of just working harder."
2. Gerard Brogan Jr., MD, senior vice president and chief revenue officer of New Hyde Park, N.Y.-based Northwell Health: "One thing we are focusing on is utilizing rapid process automation or what some people refer to as bots, or other types of technology solutions to automate areas that lend themselves to that type of strategy and to redeploy folks to those parts of the revenue cycle that still require human touches, conversations with insurers, conversations with patients."
3. Tina R. Strawn, RN, administrative director of operations for patient financial services at Houston-based Harris Health System: "To improve the patient experience related to their portion of a bill, there needs to be a tool that assists patients in their understanding of their patient financial responsibility (billed charges, allowed amount, coinsurance, copayment, deductible, out-of-pocket, premium, in-network vs. out-of-network, etc.) when compared to the monies they've already paid for the year. Based on our conversations with our patients, we find that our patients are highly dependent on their payers to pay the claims appropriately, and they trust the patient financial responsibility information coming from their payers. In fact, the patients are willing to accept the patient financial responsibility as assigned by their payer even when the information is wrong (i.e., the payer processes the claim as if the provider was out-of-network when the provider was in-network, increasing the amount the patient had to pay toward the services provided)."
4. Margaret Schuler, system vice president of revenue cycle at Columbus-based OhioHealth: "Eliminate denials and bring payers and providers together to agree upon utilization standards, and eliminate the need for administrative denials due to lack of authorization or medical necessity."
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