Tips for Improving Your Revenue Cycle Management

For healthcare providers, one of their primary focuses is to provide quality care to their patients. Consumers rely on healthcare providers to do anything they can to improve their care, and a lot of times, do to not turn away patients in need.


Unfortunately, a lot of time can be spent to maintain a steady stream of cash flow for your practice or hospital or chasing down payers. Healthcare providers used to count on payers (private and public) to provide a vast majority of their revenue, but that is no longer the case.


With the increase reimbursement issues, and as high-deductible plans become more widespread, healthcare providers are finding it more and more difficult to collect payments.  


Favorably for providers, automating revenue cycle processes with electronic transactions can save you both time and money.


Healthcare providers can implement these strategies for improving healthcare revenue cycle management:

  • Easily tracked healthcare revenue


For the purpose of improving your revenue cycle management, it is important to track data in order to measure performance. The data collected will tell healthcare organizations if their staff is efficiently performing in order to get a fast and accurate reimbursement.


Sandra Wolfskill, Director of Healthcare Finance Policy and Revenue Cycle MAP at the Healthcare Financial Management Association (HFMA) recommended that “using financial and clinical date, organizations should develop and track key performance indicators (KPIs).”


These indicators should be able to tell you the average time taken to submit a claim, the average reimbursement rate, etc.

  • Implementation of Electronic Remittance Advice (ERA) & Explanation of Benefits (EOB) posting


To implement ERA and EOB your organization will improve the reimbursement cycle and streamline workflow.


According to the Electronic Remittance Advice Toolkit by the American Medical
Association (AMA) by adopting ERA you can expect to increase practice automation, reduce manual tasks, ease coordination of benefits processing, receive faster payment, and free up staff time by replacing paper remittance statements with efficient payment processes.


You will be able to process your claims much faster and reduce the number of days your receivables are outstanding. These features will turn into cost savings for your practice and free up staff time for patient care by reducing any manual processes.

  • Make it easy for patients to pay


To make it easy for patients to pay, not only will you achieve patient satisfaction but you will also make it easy for your practice to collect payment from patients.


Consider collecting payment through a patient portal, send reminders on what bills they are expected to pay prior to their upcoming visit, use of automated statements, keep credit cards on file if allowed by the patient, and offer payment plans.



  • Automated prior authorizations and eligibility


A recent MGMA report stated that about 86 percent of healthcare organization leaders reported an increase in prior authorization requirements in 2017.


The demand for prior health plan approval for certain medical tests or medical procedures can take up a lot of time resulting in the delay of treatment and driving up administrative costs.


For that reason, payers are increasing prior authorization as well as coverage eligibility requirements in an effort to reduce unnecessary administrative costs.


Healthcare providers can ensure a smooth revenue cycle management by switching to automated processes. Staff will reduce the time it takes for them to get prior authorization and eligibility requirements and focus their time on other high-priority tasks.

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