7 Best Practices for Revenue Cycle Management

A strategy for managing the revenue cycle empowers healthcare providers to efficiently gather timely payments from both patients and insurance companies. While most medical practices already have systems in place for revenue cycle management (RCM), maintaining profitability can become challenging within the intricate realm of claims filing and coding.

How can you enhance your revenue cycle management to optimize your healthcare practice's financial outcomes? Here are our suggestions for implementing effective revenue cycle management best practices.

#1 Place Patients and Their Preferences

 At the Forefront Ensure that your patients are well-informed and involved in the payment process. Cultivating a transparent and communicative relationship between patients and providers is essential for long-term success and loyalty. Offer patients clear explanations regarding billing expectations and various payment choices. By doing so, patients will be less likely to be taken aback by medical bills and will feel more empowered in managing their care and financial responsibilities.

According to a study by InstaMed, a J.P. Morgan company, 74% of consumers and 80% of millennials favor online payment methods for medical bills. An astonishing 74% of millennials would consider changing healthcare providers for a better payment experience. Currently, 75% of providers still rely on paper statements and manual processes for collections. Rev Patient Collect, a patient payment platform, was designed to cater to patient preferences.

#2 Obtain Payment Information in Advance

Rather than waiting until after a patient's appointment to discuss payment options, gather payment information during the appointment booking process. This information may include recording insurance details or credit card information to keep on record for services not covered by insurance plans.

 #3 Streamline Claim Authorization

 Through Automation In conjunction with collecting upfront payment information, employ an automated system to simplify the claim authorization procedure. This approach will save your staff significant time by streamlining the submission of individual claims. Additionally, patients will receive prompt information about whether a service is covered or not.

#4 Enhance Claim Filing Speed

Even when insurance claims are filed promptly, processing can still take up to 30 days. To mitigate delays in payments, prioritize submitting claims right after a patient has received a service. This proactive approach ensures that filing deadlines are met and payments are received on schedule.

#5 Effectively Manage Claim Denials

 Not every claim will be approved by the insurance provider. Common issues include missing information, incorrect coding, late filing, eligibility problems, or duplicate claims. Many of these errors can be prevented through streamlined claims processes and meticulous attention to detail. Keep track of claim denials to identify consistent mistakes or patterns and collaborate with your team to address these issues before filing.

#6 Monitor Balances in Accounts Receivable

 The accounts receivable (AR) balance reflects outstanding payments due from patients and insurers. While every healthcare practice has an AR balance, it's important to keep the percentage of balances exceeding 45 days old in check. The ratio of AR balances over 45 days old indicates the effectiveness of your payment collection strategy and may reveal persistent filing errors. In the past, monitoring AR over 90 days was the industry norm. However, depending on the payer, some claims are settled within a week of submission.

At JKS Outsourcing, we monitor AR based on historical lag times categorized by payer. For instance, if a payer typically processes payments within 15 days, we start addressing claims from that payer if payment hasn't been received within the 15-day window. Aging AR balances signify uncollected revenue and increasingly burden your practice financially.

#7 Embrace Technological Investment

You don't need to handle revenue cycle management in isolation. Invest in an RCM system to assist you in managing patient information, filing claims punctually, handling claim denials, and automating authorization and eligibility procedures.

The demands of intricate coding and filing requirements can overwhelm your administrative staff on a daily basis. RCM systems offer crucial support, enabling your in-house team to focus on other responsibilities and deliver optimal care to patients.

Revolutionize Your Approach to Revenue Cycle Management with JKS Outsourcing

At JKS, our integrated RCM solution merges efficient claim management with personalized performance consultation, presenting clients with a fresh perspective on their revenue cycle. Whether for small physician groups or hospital systems, our emphasis is on comprehensive support that surpasses mere progress reports and automated features.

Our entrepreneurial ethos, commitment to client satisfaction, and expertise in collaborating with healthcare professionals uniquely position us to deliver enduring value to our clients. How will JKS revolutionize your revenue cycle? Reach out to us today to discover more about our solutions: info@jensenkobain.com