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MHRCM Solutions

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(+1) 512 800 6431
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MHRCM Solutions

CALL US NOW :

(+1) 512 800 6431
(+1) 270 495 3261

MAILING ADDRESS :

sales@mhrcm.com

LOCATION ADDRESS :

Suite 101, 1250 S A W Grimes Blvd, Round Rock,
Texas - 78664, USA

Top 7 New Strategies for Revenue Cycle Management Excellence: Guide for RCM

Revenue Cycle Management (RCM) is vital for healthcare organizations to ensure financial strength and operational efficiency. It contains processes from patient enrollment to claims processing, billing, and collections. Proper Revenue Cycle Management Strategies maximize revenue capture, reduce claim denials, and accelerate reimbursement cycles. By optimizing RCM in Medical Billing, healthcare organizations can improve cash flow, support profitability, and deliver better patient care and experiences.

However, standard RCM processes often encounter few challenges. These include manual data entry showing errors, inefficient claim processing driving delays in reimbursement, lack of real-time visibility into revenue level, and difficulty in identifying and addressing blockages. These problems result in increased costs, prolonged payment cycles, and reduced revenue. In such a strategy, embracing technology-driven solutions can assist in overcoming these challenges and streamline RCM in Medical Billing operations.
Technology has a profound impact on the efficiency and effectiveness of the Healthcare Revenue Cycle. Here, we will understand the Top 7 New Strategies for Revenue Cycle Management Excellence and Guide for RCM.
Top Revenue Cycle Management Excellence

1. Begin At The Beginning

Getting accurate information in front initiates patient scheduling and patient registration from a Revenue Cycle Management view. This supplies the bottom work by which claims can be billed and collected most efficiently and effectively possible,” said Gary Marlow, Vice President of Finance for Beverly Hospital and Addison Gilbert Hospital.
“The last thing you want is bringing a claim submission kicking back to them then holding to work their way via the institution. If you get the details upfront in as pleasant a manner as possible, it saves suffering for the patient and family if the claim is processed and cleared judiciously.”
“We often have regular patients. They may start with an ER visit, end up in the OR, and finally, on a patient floor. Let’s take care of that benefit understanding from the very beginning. They can make wiser choices for themselves as they go along,” stated Lynn Giddens-Branscum, Revenue Cycle Management Director at Wise Health System.
“We are in the method of changing the point where that type of contact occurs with the patient. Previously, that conversation wouldn’t happen until the patient had met with their physician and had a practice scheduled.”
“We are really trying to identify the challenges our patients face and estimate and weigh those against challenges organizations face related to bundled expenses and just everything as a whole. I don’t think any piece of Revenue Cycle Management makes or breaks an organization. It’s the revenue cycle as a whole.”
Seven Strategies for Revenue Cycle Management

Three Steps to Enhance Upfront Collections

Those Revenue Cycle Management statistics may assist practice employees in understanding why patients want upfront information about payments and the portion for which they will have accountability. It also highlights the necessity to work with patients to proactively get prompt payment. Here are three steps to help improve revenue and improve your bottom line in Healthcare Revenue Cycle:
  • Before the appointment  – before the patient even shows up for an appointment, get prior approval from the insurance company. Whether conducted in-house by staff or outsourced to a company, you and the patient will have a more satisfactory understanding of what the total amount due from the patient will be. You can deliver this information during a reminder call – a fantastic way to decrease no-show appointments.
  • At the appointment  – collect payment from the patient before they visit the physician or additional medical professional. It allows you to confirm that the patient understands what to expect and to collect the payment without follow-up calls or other methods. If your staff feels uneasy starting a conversation on payments, put a script concurrently and practice initiating a talk of payment and providing appropriate answers to questions.
  • After the appointment   – are you still sending out mail notices? Are they straightforward to understand? A proven way to collect payment – and improve patient pleasure – is to communicate with the patient in the way they prefer. For many patients, that contact channel would be electronic, including patient portals, rather than print messages.
While the patient is liable for a growing portion of the cost of the Healthcare Revenue Cycle, insurance still plays a significant role in achieving healthy Revenue Cycle Management Services.

2. Go Back to Revenue Basics

Revenue Cycle Management success is about the art of clarity, asserted Neerav Jadeja, Administrator at Paradise Valley Hospital.
“If you’re getting in a certain amount of revenue, you can’t have expenditures that exceed that revenue. It seems very basic, but somebody doesn’t look at it that way.”
“Healthcare is constantly changing, so maintaining financial strength is challenging, particularly in a low-income area. We are always looking to confirm we are reimbursed for the services we deliver and to enhance our communication with our payers on claims to guarantee financial stability and balance our large charitable care subsidies.”
3. Use Data To Tell Your Story
“There’s little you can usually do in the short run around volume and rates of payments, which shifts the focus to the cost side,” stated Sally Mason Boemer, Senior Vice President of Finance at Massachusetts General Hospital.
“A lot of my time and effort is making sure that people understand the Healthcare Revenue Cycle environmental context. It’s tough to motivate people to focus on lowering costs if they’re not sure that you’re collecting every dollar that you’re owed for the work you are doing.”
“All you need is information to compose your story and convey it to your crew and get them along with you on the Healthcare Revenue Cycle journey. When you’re working outside of the organization for Healthcare Revenue Cycle, I think there’s also the expectation of more transparency and understanding what the cost of RCM in Medical Billing healthcare is and why the system works how it does Revenue Cycle Management Services.”
4. Keep Going Back To The Drawing Board
“We address expenses in the Healthcare Revenue Cycle on an ongoing basis. We look at it every couple of years as it’s not a one-time event,” explained Tom Lichtenwalner, St. Luke Hospital’s Chief Financial Officer.
“We have specified Medicare cost-reduction initiatives, and our goal is eventually to split even on the Medicare side. Our thought is that if Medicare is our biggest customer, it’s probably 40 percent of our business. Shouldn’t we at least break even? If you can’t make money off your biggest client, it puts a strain on the rest of the Healthcare Revenue Cycle organization.”
5. Reject A Maintenance Mode Mentality
“The purpose of the Revenue Cycle Management Services is to maximize cash flow and net revenue. For that reason, we are continuously looking to improve performance. We will always look at some way to tweak it a little bit more, get more efficient, reduce cycle time and waste,” remarked Rick Lyman, Vice President of the Revenue Cycle at Advocate Health Care.
“What we’re really concentrated on is net-revenue progress. It’s an improvement on denials, underpayments, and reducing poor debt. Also, we need the Healthcare Revenue Cycle to be efficient. We don’t have the luxury of reimbursement being down and cuts to Medicare of overstaffing. We always need to cut costs through RCM in Medical Billing, and we’ve got to benefit our hospitals.”

Consider A Consolidated Billing Program

“Historically, the Revenue Cycle Management Strategies have been regarded as overhead, support, or shared services. RCM in Medical Billing is basically an operational expense to be controlled and minimized as much as necessary. Given the complexity of healthcare and the importance of consumerism, the Healthcare Revenue Cycle industry really needs to begin to look at the Revenue Cycle Management Services as a strategic business unit,” stated Jeff Hurst, Florida Hospital’s Senior Vice President of Finance.
“Generally, the whole Medical Billing process post-service is very difficult for a patient to understand. They get numerous bills from multiple providers. You always get the patient who calls in and says, ‘I have five bills from multiple providers, and I don’t know who I owe. Can you help me?’”
“We’ve got to move better towards a streamlined billing process like Revenue Cycle Management Services that’s simple for the patients to understand in terms of helping them satisfy their debt. We need to become more relaxed on the back end. Revenue Cycle Management Strategies serves all.”

Merge The Healthcare Revenue Cycle with The Supply Chain

Healthcare Revenue Cycle Supply Chain
Integrating Healthcare Revenue Cycle Management with Supply Chain Management is crucial for enhancing efficiency and achieving strategic advantages. According to researchers in a study from the Health Sector Supply Chain Research Consortium, many organizations in the healthcare sector manage these functions independently, only occasionally addressing connections between the two areas based on anecdotal evidence.
To optimize financial goals and ensure a consistent revenue stream to support clinical efforts, hospitals, and healthcare systems need to break down the silos between RCM and Supply Chain Management. By adopting a more integrated approach, organizations can create a seamless flow of processes.
The intersection of RCM and Supply Chain Management holds the key to strategic advantages in the healthcare industry, as financial success is paramount in sustaining clinical operations. Hopefully, the strategies mentioned above can help you go around more efficiently.

Focus on where you want to go

Optimizing the Healthcare Revenue Cycle is key to financial strength and operational efficiency. The seven strategies outlined, from prioritizing accurate upfront information to merging RCM with Supply Chain Management, offer a comprehensive guide for the success of Revenue Cycle Management Services.
By addressing challenges like claim denials and inefficiencies, organizations can improve cash flow, reduce costs, and enhance the patient’s experience. Revenue Cycle Management Strategies not only ensure financial stability but also uphold a commitment to delivering quality patient care. Implementing these insights will transform the RCM in Medical Billing, fostering efficiency, transparency, and sustained success. Revolutionize your RCM today with MHRCM to elevate your healthcare operations and achieve lasting financial success.
About the Author
Elena Kinsley

Elena Kinsley is a seasoned Content Strategist and Chief Technology Officer (CTO) specializing in medical revenue cycle management (RCM).

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