Traditional healthcare revenue cycle organization is all about managing the metrics. This is essentially equivalent to teaching the test to students to measure their performance. The revenue cycle is an ongoing transactional business. If that didn’t issue enough of a challenge, there’s this: the cycle is also complicated by management impacting revenues.
Let’s take a look at what moving away from the metrics and toward digital growth can mean for health systems’ bottom lines.
What the metrics don’t tell us
There’s a fundamental problem in today’s highly scrutinized billing compliance environment. Revenue cycle leadership is often so focused on the metrics that they fail to coach staff on underlying negative performance behaviors. These behaviors are impacting the results.
Hitting the numbers, especially in a production-centric health system, often means negative employee behaviors and consequences in other areas. These include not working the complex claims and spending an inordinate amount of time on administrative work. Both may result in:
- denied claims
- failed claims
- unresolved recurring operational issues
Where technology builds a bridge
Healthcare systems and facilities are in a transition phase. On the one hand, they are using technology to:
- hit record revenue numbers
- streamline workflows
- revise denials management procedures
- reduce the burden on time consuming administrative work
- aid clinical documentation
- create a more patient-centered experience
But on the other hand, some in the world of revenue cycle management (RCM) are slow to invest in technology. When leadership sees the long-term value of investing in automation solutions, employees and patients reap the benefits. Such solutions help employees focus their time on big ticket concerns such as value-based care and clean claims.
They also accelerate recurring, standardized tasks such as clean claim transactions and accounts receivable. With the right technology in place, claims managers and revenue collection teams can work on the more complex claims and challenges.
How automation secures the cycle
Investing in revenue cycle management technologies that integrate into automated streamlined workflows is crucial. Those solutions boost overall productivity and efficiency for healthcare professionals. That means they also substantially decrease labor costs and human errors. Bringing automation solutions to the front end of the revenue cycle is the ideal place to start. That way, patient access and registration can establish performance and efficiency throughout the entire revenue cycle.
Generally, front-end revenue cycle tasks lay the foundation for a clean claim. Automation within these tasks can:
- streamline front-end tasks
- allow revenue cycle leadership to devote resources to more complicated claims
- help organizations prevent common errors that lead to claims process issues
- lessen the burden of non-clinical tasks on healthcare providers and their professional teams
This means bringing automation to tasks such as prior authorization, registration, patient data collection, and eligibility. Technology can provide teams with the ability to collect the necessary information for patient billing and other back-end tasks. For instance, tools today are widely available to help healthcare professionals collect data before a patient even shows up for an appointment.
With the right investment in automation technology solutions, medical practices are able to:
- verify coverage and demographic data before patient service limits care
- manage patient service revenue concerns
- manage charge capture issues
- improve practice management
Healthcare professionals are then free to focus on improving the experience of their patient populations. They can also devote more resources to time-consuming (and revenue boosting) claims.
Why embracing technology matters
The front-end of the revenue cycle contains a series of complicated processes that are crucial for collecting revenue. Many healthcare organizations are experiencing the subsequent impact caused by errors and inefficiencies in the front-end. By effectively integrating automation, organizations can create streamlined processes to reduce errors, improve efficiency, and increase the bottom line.
Embracing automation in the revenue cycle can have a significant financial impact for providers. It will allow staff members to maximize their efforts in providing value-based care. It will also allow for an increased number of accurate claims, a solution that will inevitably lead to fewer denials and rejections.
Despite some being slow to warm up to it, automation is here to stay. It’s designed to complement the human working element by giving providers a digital capability that didn’t exist a few years ago. It will undoubtedly continue to help hospitals and health organizations perform better. As a technology solution with abilities that consistently evolve, it will:
- cut through pain points
- minimize repetitiveness
- enable employees to take on higher value opportunities
We’re here to empower you
Harmony Healthcare’s Revenue Cycle Management solutions provide interim expertise that optimizes your facility and helps you collect more.
Discover how our solutions can help your organization:
- optimize reimbursements on the back-end
- improve your patient accounting processes
- ensure sustainable results in patient care management and financial performance
- discover new opportunities for revenue enhancement
See how the right service partner can provide a better solution for your staffing needs here.
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