Healthcare is not just a welfare industry but it is also a business. Doctor are working day and night for human welfare (improves health and wellness), but they are paid for this. Their pay is a fraction of the total revenue a hospital generates. The source of this revenue is payments made by patients. Hospitals make thousands of dollars per day. How is this all managed? It is the Healthcare revenue cycle management responsible for the functionality of the healthcare institute. The entire process of setting up a patient account, receiving payment for health and wellness services, and every phase in between is included in the revenue cycle. Therefore, health systems depend on efficient revenue cycle management (RCM) to track the patient journey, handle claims, and guarantee that the institute is paid for its services.
Today, RCM encompasses much more than just billing and payment collection. Traditional, labor-intensive (often manual) ways of managing the revenue cycle need a wide range of resources and have unacceptable error margins as the healthcare industry expands. On the other hand, revenue cycle solutions do not support customization or EMR and payer data connectivity.
A thorough, structured, and data-driven revenue cycle approach is necessary given the current state of healthcare. It is not affordable for the organizations to miss payments, thus the volume lost as a result of COVID-19 has increased the need to improve revenue cycle management.
Healthcare organizations that use data to support thorough and accurate revenue cycle management significantly enhance their financial results in these key ways:
- Cutting down denials
Each healthcare organization loses an average of five million dollars annually due to claim denials during the revenue cycle process. Employing an analytics solution to combine data from various sources and comprehend the causes of the denials can help organizations recoup some fraction of the loss. With such knowledge, healthcare systems may put denial prevention measures and denial recovery protocols into place.
- Boost Collections
Self-pay accounts are increasingly the main cause of bad debt for hospitals and healthcare systems, with patients bearing a growing share of the cost of their healthcare. Over fifty-five dollar billion in healthcare revenue loss is a result of bad debt each year. To avoid bad debt, healthcare institutions require strategy-driven patient collection procedures.
- Improve DNFB Efforts
One significant method hospitals can enhance revenue cycle performance is by managing discharged not final billed (DNFB) cases, when bills remain unfinished owing to coding or paperwork errors. Fulfilling a target for DNFB improvement stays a serious issue, though, without analytics to reinforce measures.
Today’s revenue cycle management must handle growing organizational intricacy while preserving financial stability in times of crisis, like the corona pandemic. Healthcare systems can satisfy these demands by using strong analytics to find opportunities to enhance the revenue stream and data-driven strategies to maintain improvements as healthcare institutes expand and new problems arise. Buy a Healthcare Revenue Cycle Management Software to enjoy benefits of this latest trend. If you are facing any issues finding RCM service providers, leave a comment.