What are the best ways to optimize your revenue cycle management process?

There are a lot of great tools to help with the automation of RCM. One of my favorites is Pearly. This software does a lot but the best is sending automatic texts and emails for patient balances.

RCM is crucial for financial success. Start with documentation to facilitate accurate coding and billing. Track claim submission deadlines to reduce denial risk. Define a system to identify and resolve claim denials. Apply corrective measures and analyze denial reasons. Automate payments and offer online portals for patients. Regularly analyze KPIs for improvement. Educate your billing and coding staff on regulations, coding guidelines, and best practices. Utilize an integrated practice management system to streamline RCM tasks, reduce errors, and improve workflow. Billing, coding, front desk, and healthcare providers should effectively communicate and collaborate. Communicating clearly and regularly helps identify and resolve issues.

Providing ongoing training for your teams is very important to ensuring that your RCM processes are being done well. Even sending out a video that teams can refer back to is a good tool.

Front end to back end RCM processes need to be reviewed on a regular basis to ensure compliance with all current coding guidelines, payer policies, and other regulatory guidance. The ever-changing landscape provides many opportunities for gaps if not monitored on a regular basis. The more collaborative the RCM process, the better chance for overall facility compliance.

Data is gold when monitoring your facility's key performance indicators. Use industry KPI's for guidance when developing facility specific KPI's. Processes vary among facilities and there is not a one-size fits all solution. Dashboards are a great visual tool for leadership as well as staff. These should be easy to understand and transparent to those with access.

In my experience building a rapport with your insurance reps is the best way to get a decent increase with your fee schedules. Also ensuring your UCR fees are a good rate for your area will help to increase revenue.

An important guideline is to create awareness of capturing patient demographics and insurance data at the point of registration. It is said that 60% of the Information needed for accurate billing and claim approval can be achieved during the registration process. If the staff is aware of their role and its impact on revenue, the errors and missed pieces will be significantly reduced thereby helping the organization achieve optimal rates of claims reimbursements.