Transform Your Practice With Revenue Cycle Improvement Strategies

Do you break out in a cold sweat whenever you see the words “claim denied”? Chances are good that your revenue cycle management process could use some (or maybe a lot) of work!

Below, you’ll learn revenue cycle improvement strategies for health systems that, when put into practice, can spare you a ton of headaches.

Understanding Revenue Cycle Management

Revenue cycle management, in a nutshell, includes all financial interactions between patients and providers. The RCM journey begins with gathering patient information and verifying insurance coverage and ends with collecting payment for work you’ve done.

Proper RCM for small practices relies on accurate billing to reduce denials and receive timely payments.

Key Strategies for Revenue Cycle Improvement

Is your RCM game on point, or is it, to put it gently, lackluster? If you have far too many unpaid bills and denied claims, your RCM strategy needs a little bit of help. Here’s how to streamline your RCM process and improve your practice’s bottom line.

Accelerate Patient Scheduling and Registration

If you’d like to improve revenue cycle management performance, start with the scheduling process. Accurate, speedy scheduling is a must for continuous improvement and steady cash flow.

How easy is it for patients to make appointments with your practice? If they have to speak to someone to book a visit, they may not even bother. Today’s patients prefer to click or text to make appointments. The fewer barriers between the patient and setting an appointment, the better.

Struggling with scheduling? Try automated systems and online scheduling tools. Many healthcare providers see their no-shows drop drastically when implementing these tools.

Automate Insurance Verification

One big reason for denied claims is failing to verify a patient’s insurance before providing care to them. Imagine that a patient schedules an elective procedure. You go ahead and do the work without bothering to check if their insurance covers it. Afterward, when you submit the claim, the insurance company says, “Sorry, that’s not covered.” Now, you have to hound the patient to pay you out of pocket, which they may or may not do.

Are your claim denial rates too high? Take corrective measures to minimize future denials by verifying patient insurance coverage and collecting prior authorizations before providing medical services. By making sure everything’s good to go with insurance beforehand, you’ll ensure a smoother claims submission process and seriously slash those annoying payment delays.

Optimize Medical Coding Practices

Coding errors are one of the biggest reasons insurance providers hand out claim denials. And if your staff has to enter all data by hand, mistakes are bound to happen. An insurance company will readily deny a claim for something as simple as spelling the patient’s name wrong. Another common mistake is entering the wrong code for a procedure.

Health systems that are struggling with claims processing and shaky financial performance should ensure that patient information and claims are error-free before submission. It can help to study denial patterns and staff performance data to identify recurring issues in patient collections. Provide regular training sessions on data entry best practices and industry changes that may affect claims management.

Implement Effective Denial Management

If you want a successful healthcare practice, you can’t bury your head in the sand when it comes to claim denials. For continuous improvement and an efficient revenue cycle, you must understand the reasons behind denied and delayed payments.

Study your key metrics for denial management to identify trends and inform your revenue cycle management strategy. Keeping tabs on key performance indicators can significantly reduce denied claims, improve financial health, and boost overall revenue cycle performance.

KPIs to watch include:

• Your cancellation or no-show rate. To calculate this, divide the number of missed appointments by the total number of scheduled appointments. Ideally, shoot for a no-show/cancel rate of 10% or less.
• Denials because of authorization. This includes denials due to no or incorrect authorization. To calculate this, divide the total value of claims denied because of authorization by the total value of all denials.
• The exclusion percentage. Exclusions are accounts that failed the benefits and eligibility checks. Maybe a patient didn’t fill out their intake form correctly, for example, or they didn’t have active coverage. Calculate this by dividing exclusions by the total number of accounts you were able to verify.
• The unbilled claims percentage. This is the number of claims not billed, also called hold claims. You may have a high unbilled claims percentage if your staff is too busy to handle the entire volume of claims each day. To calculate this KPI, divide the number of unbilled claims by your average daily claim volume.
• Billing lag. This depicts the amount of time between submitting a claim and getting paid. Ideally, your billing lag should be less than 48 hours, but it can go up to seven days for hospitals. To calculate billing lag, subtract the date of service from the claim bill date.
• Clean claims. This is the number of claims accepted without any problems. It’s best to shoot for a clean claim ratio of at least 98%. Calculate yours by dividing the number of claims accepted without issues by your total number of claims.
• The initial denial percentage. This depicts the number of claims denied when submitted for the first time. Figure this one out by dividing the number of initial claim denials by the total number of claims.

Enhance Patient Billing and Communication

To ensure a smooth revenue cycle process and reduce denied claims, be certain that patients understand their financial responsibilities before healthcare providers lift a finger. Make sure they know, for instance, that they’re on the hook for the whole bill if insurance refuses to cover a procedure.

Consider implementing medical billing software to improve the ease of patient payments. You may also consider offering patient financing options, such as payment plans. Offering multiple payment options makes medical billing easier for you, and your patients will be pleased as punch, too.

Leverage Data Analytics

Implementing data analytics tools is an excellent way to transform revenue cycle management and improve financial health. You can use tools like software with artificial intelligence to gain valuable insights into accounts receivable, patient care statistics, and the overall revenue cycle process. With regular audits, your practice will enjoy improved patient satisfaction and better financial outcomes.

Invest in Staff Training

Health revenue cycle improvement relies on an informed staff. Train your claims processors on regulatory changes, handling outstanding balances, electronic health records, and efficiently managing claim denials. Regular training goes a long way toward minimizing delays in accounts receivable and improving your practice’s financial performance.

Utilize Advanced Technology Solutions

Looking for a simple way to improve revenue cycle management? Try implementing automated healthcare revenue cycle software. This software automates routine claims processing tasks and provides real-time data that you can use to improve patient care.

One of the biggest perks of such software is that it greatly reduces the chance of manual errors. Additionally, the software can identify areas in your RCM process that could use improvement.

Continuous Monitoring and Improvement

Healthcare revenue cycle management isn’t a set-it-and-forget-it thing. Once you’ve set up your revenue cycle management processes, you’ll need to review them regularly. Conducting periodic audits allows you to identify inefficiencies and implement fixes that can improve both your bottom line and the patient experience.

If your practice needs help with revenue cycle management, consider outsourcing to an RCM provider. They’ll handle the hard work for you, allowing you to focus on what you love most about the job: your patients.

The Role of Weave in Revenue Cycle Improvement

Below, learn how Weave can help with healthcare revenue cycle management.

Phones and Texting

Weave comes with automated tools for your phones that make keeping in touch with patients a snap. You can chat with patients via phone or text, whichever they prefer most. So, if you’re having trouble getting patients to pick up the phone, you’ll love Weave.

Appointment Reminders

Does your staff spend too much time calling patients to remind them of appointments? Weave includes handy appointment reminders that automatically alert patients when it’s time for a visit. As a result, you’ll enjoy fewer no-shows and better treatment plan compliance rates.

Online Scheduling

With Weave, instead of speaking to a live person, patients can easily make an appointment by text whenever it’s convenient for them. Your staff will spend less time on scheduling and have more time for other important tasks, like effective revenue cycle management.

Billing and Payments

Healthcare providers get paid faster with Weave billing and payments. Allow patients to pay however it’s convenient for them, whether that’s by phone, text, or email. You’ll wonder how you ever handled revenue cycle management without it.

Digital Forms

Do your healthcare providers spend too much time on patient intake? Why not automate the process with Weave? Our digital forms make it easy to collect patient information and reduce the chance of errors, thereby improving your practice’s financial outcomes.

Email Marketing

Does email marketing work for healthcare providers? Yes! Health systems like yours can stay in touch with patients by offering helpful lifestyle advice and the occasional discount on your services. With Weave, it’s a breeze to stay top of mind with patients.

Weave Is Your Ticket to Effective Revenue Cycle Management

Looking for the golden ticket to revenue cycle improvement? Give Weave a shot! When you throw Weave in the mix, you’ll be amazed at how much more smoothly your RCM process goes. Say goodbye to billing headaches and no-shows and hello to a practice so efficient that it practically runs itself.

Get your demo and see how Weave will take your practice to the next level today.