3 Ways to Improve Revenue Cycle Processes
Updated June 4, 2023
Originally Published August 25, 2023
If you’re a private health clinic or local independent provider, generating revenue keeps your doors open. You should develop strategies to improve your revenue cycle and ensure you're not leaving behind any loose cash, billing your patients inaccurately, or taking too long to process insurance claims.
Streamlining your billing processes can result in more revenue and happy customers (patients). With that in mind, let’s talk about 3 ways to reduce inefficiencies and strengthen your financial outcomes.
1. Streamlining Coding and Billing Procedure
Streamlining coding and billing procedures is a smart way to boost your revenue cycle. It can help reduce errors and delays in the billing process, resulting in faster and more accurate reimbursements. A recent survey found that 74% of hospitals are actively automating some portion of their revenue cycle operations, highlighting the industry's move towards more efficient processes. These are some ways that streamlining coding and billing procedures can improve the revenue cycle process:
Improved accuracy – When coding and billing steps are refined, there is a lower chance of errors occurring in the billing process. This can help ensure that claims are processed accurately and that payments are received quickly.
Faster claim submission – Improving coding and billing workflows can help expedite the claim submission process. This can help reduce the time it takes to receive payments and improve cash flow.
Increased efficiency – When these procedures are optimized, staff can devote more time to patient treatment and less time to administrative duties. This helps improve overall efficiency in the revenue cycle process.
2. Automating Claims Submissions and Follow-Ups
Ready to take the next step? Automating claims submissions and follow-ups can significantly improve your revenue cycle.
This involves using technology and software to streamline the process of submitting claims to insurance companies and following up on the status of those claims.
Automation reduces errors and inaccuracies in claims submissions, resulting in quicker payments and fewer denials.
Automated software can also help identify claims that require additional documentation or clarification, allowing billers to address these issues before submitting the claim.
In addition, automating follow-up on claims can help providers stay on top of unpaid or denied claims and take action to resolve them more quickly. This can result in improved cash flow and fewer lost revenues.
Automating claims submissions and follow-ups improves the revenue cycle process by increasing efficiency, reducing errors, and helping providers get paid faster and more accurately.
3. Structured Processes to Manage Denials
Denials happen; having a plan makes all the difference. Denial rates have steadily increased, with providers seeing rejection rates as high as 10% to 15%. Structured processes to manage denials can be an effective strategy to protect your revenue. Here are some steps you can take to implement this strategy:
Identify the reasons for denials – The first step is to identify the reasons for rejections. This can be done by analyzing denial data and identifying trends in denial types and causes.
Create a denial management team – This team should include members from various departments, such as billing, coding, and clinical staff.
Develop a denial management plan – Develop a plan that outlines the steps that will be taken to manage denials. This plan should include workflows, timelines, and responsibilities for each team member.
Implement denial management technology – Implement technology like denial tracking software to help manage the process. This software can help identify patterns in denials, track appeals, and automate workflows.
Educate staff – Educate staff on the importance of managing denials and the steps they can take to prevent denials from occurring. This includes training on coding and billing best practices and providing feedback on denied claims.
Conclusion
Efficient revenue cycle processes drive the success of healthcare organizations. Implementing strategies such as streamlining coding and billing procedures and automating claims submissions can help improve the revenue cycle process. The result: fewer errors, quicker payments, and improved patient satisfaction. With the right tools and procedures, healthcare providers can increase revenues while remaining focused on delivering quality patient care.
