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%.
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 healthcare, as it is in many industries, cash is king. Of course your financial team will deep dive into financial performance throughout the year, but on a regular basis many hospitals and practices assess the health of their revenue cycle based on cash flow alone. However, accounts receivable is only one metric to monitor. Here are five additional simple key metrics that have been identified by the AAFP to measure regularly to ensure the health of your revenue cycle.
Insurance claim denials plague most hospital and medical practice billing offices, although to what extent can be hard to determine. There is a noticeable lack of information on the industry average for denied claims.
Are there consistent errors within your medical accounts receivable management processes that are restricting your organization’s cash flow? There are a few common problems that plague healthcare providers that can be avoided in a few simple steps.