Revenue cycle processes have had to continuously evolve over the years to keep pace with the rapid changes occurring in the healthcare industry. As a result, RCM vendor partners are now utilizing technology that hospitals do not have access to on their own. To be successful in this new climate of increasingly complex payment models, providers need to focus more on how to streamline their processes to optimize reimbursement rather than on insurance denial management.
Topics: healthcare revenue cycle management, insurance denial management, patient engagement, insurance reimbursement, insurance claim denials, process improvement, healthcare business process outsourcing
How well are your revenue cycle processes working? A good indicator is the age of your accounts from final bill or claim date. Generally, a clean claim gets paid in 30 days or less. If a claim is older than 60 days there is typically something wrong with it, and once you pass 180 days, collectability on that account dips to 5%.
By now you’ve heard that engaging patients in their care is essential to positive outcomes - and therefore reimbursement - so many times you’ve lost count. You’ve read the guides on how to develop better engagement campaigns (psst…if you haven’t, we have one for you here), attended sessions on the importance of activation at association events, maybe you even created focus groups within your own facility to determine how you can empower patients to take control of their care. But all the training and campaigns come down to one thing: proper communication.
In healthcare, as it is in many industries, cash is king. All healthcare systems have financial teams to dive deep into performance throughout the year, but on a regular basis many hospitals and practices assess the health of the revenue on cash flow alone. However, even at face value accounts receivable is only one metric to monitor.
Implementation of a new Electronic Health Records system (EHR) is an expensive endeavor. Up-front costs can be enormous, but there are also many hidden costs that can be extremely problematic for hospitals and physician groups during the conversion process. Outsourcing legacy support can take some of the strain off your revenue cycle and your staff.
To properly monitor, manage, and maintain your revenue cycle processes you must first understand where they are and how they got there. This is where benchmarking comes in.
In recent months a number of our MedCollect clients have asked whether they can attempt to collect from a patient’s estate after the patient has passed and, if so, how to go about it. Whether to attempt to collect a patient’s account balance after their passing is a business decision every healthcare organization must make, and if yours has decided to pursue these balances there are a few key regulations to consider. Please note that the regulations discussed in this article are part of the Fair Debt Collections Practices Act (FDCPA) and therefore apply to third-party debt collectors, like your medical collection agency.
As out of pocket costs increase and deductibles rise, healthcare organizations of all sizes and specialties are seeing an increase in high-balance accounts. Without much assistance from insurance patients are looking for new and better payment options. Payment plans can be a valuable option for both the patient and the provider when administered properly. So why aren’t they working for you?
We are proud to welcome you to the future of healthcare revenue cycle management – welcome to Meduit! Please allow us to introduce ourselves and share a little bit about what you will find here on the Innovation Lab Blog. Then we want to hear all about you.