Cultivating a Revenue Cycle Success Mindset

Using a flexible revenue cycle solution that can manage the current range of payment models (such as bundled payments, VBP, MACRA, CPC, etc.) and account for any issues that might come along is key for revenue cycle success. Through collaboration with an innovative partner, your revenue cycle can deliver financial predictability that will stop revenue leakage and increase productivity.

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The key to a successful revenue cycle is a flexible solution that can be adapted to a range of payment models. By collaborating with an innovative partner, your practice will achieve a more predictable financial performance which will lead to a stronger competitive advantage.

An innovative partner will automate redundant tasks, provide accurate reimbursements, and deliver a patient centric approach with data driven decisions. So how do you get there? We have outlined three ways to help you rethink your current processes.

How do You Optimize Front End Collections?

A successful revenue cycle mindset begins with your front-end staff. These are your receptionists, nurses and intake providers that gather the necessary information upfront to ensure claims and payments are processed effectively.

  • Find out why you’re doing what you’re doing. Look at your systems and processes and ask if they are the best and most productive way to do things.
  • Regularly audit your current system and processes noting any inefficiencies that might be leading to a loss in overall revenue. On average, hospitals lose around 1 percent of their potential net revenue due to missed charges and loss of productivity. Electronic claims processing takes 30% less time compared to manual processing. Today, charge capture and file transfers can be performed using automated timers and natural language processing with little to no manual intervention (see our 5 Best Practices for Healthcare Revenue Cycle Mangement post for more tips.)
  • Centralize the pre-loading/pre-arrival process for your patients – this limits the points of access to reduce gaps in accountability.
  • Provide eligibility verification before services are rendered. Many patients fear the amount of the bill that they will receive. Providing fees and eligibility up front helps the patient be better prepared to handle the cost. Software solutions like ImagineAIvalidate when a patient is eligible for primary insurance listed on the visit and/or your list of top payors before the claim is sent to insurance. Once you receive the positive eligibility response, the AI solution will add a note to the visit with the patient’s identified payment information.
  • Are you using automation? Usually automation can help streamline your process. Identify ways to automate your most time consuming and labor-intensive processes. Or if you’re not sure which aspects of your revenue cycle can or should be automated, reach out to a trusted expert or consultant.

Do You Have the Right People, In the Right Place, Doing the Right Thing?

If not, it may be wise to take an inventory of your staff and see who you can reallocate to hone their skills and/or address any training gaps.

As automation comes to the forefront of modern medicine it may be time to see if eliminating the chance for human error will increase functionality of your business. Maybe Sherri from AR can move to collections or marketing where her skills are put to better use, and an automated provider can reduce the manual data entry which can help speed along claim processing.

Hospitals across the country lose approximately $262 Billion per year on denied claims from insurers (reference: modern healthcare). What is your take of that lost revenue? If recaptured, could it further your business goals, provide new equipment or bonuses for those loyal employees? It may be worth looking into what an automated system to do for you.


Do you Have a Succinct Process?

Where is technology having the biggest impact on financial outcomes? Are your workflows optimized to keep productivity high and reduce the impact of exception-based claims? Have you adopted an automated process?

Ultimately this is about change management – change for your people and to your processes and policies, supported by technology. The tools you choose to use must provide top functionality and be able to communicate seamlessly with the other solutions you have in place.

Externally, the ability to exchange data with partners is increasingly important as more and more offices are moving to a cloud or web based system.

ImagineSoftware has seamless integration with many current partnership systems to ensure an easy transition when implemented. We have a commitment to ongoing training for your staff, and increasing your revenue through automated processes. If you’re still unsure, call our team so we can set up a demo for you.

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