two doctors with big tablets and a huge piggy back with gold coins showing how to improve rcm

Ways to Improve RCM in Healthcare

You’re always looking at your bottom line to find ways to increase practice revenue. But the solution doesn’t have to be another budget cut or marketing campaign — the solution may lie in revenue cycle management (RCM) improvement. 

Neglecting to maintain and manage current revenue streams often leaves providers with outstanding aging accounts. Poor revenue management may also lead to accounts being written off as “bad debt.”

The Basics of Revenue Cycle Management

Revenue cycle management in healthcare is the consistent flow of providing patient services and getting paid efficiently and appropriately. Mismanaged revenue cycles can have a variety of issues  from unpaid patient bills to an inefficient claims process.

There are basic elements that you need to take into account when trying to improve your RCM.

  • Look for new tools like electronic health record (EHR) systems with built-in rules that improve revenue cycle management.
  • Make sure you have sufficient resources to account for the administrative costs of healthcare. 
  • Understand employee expenses, technology costs, building overhead, and more — all of which affect your bottom line. 
  • Find ways to make sure your revenue cycle is working efficiently to bring in cash for business operations.

You’ll need consistent revenue cycle management improvement initiatives to enhance RCM processes, which will allow you to continuously provide care while generating profits.

6 Ways to Improve RCM for Your Practice

Improving your revenue cycle doesn’t have to be a tedious process. No matter your budget, there are strategies that small and large practices can use to increase profits and improve the bottom line.

Implement these six strategies to help improve revenue cycle management for your practice.

Hire staff members with experience in patient eligibility and claims management

 

Staff members should know about complex RCM processes. Hiring staff members without experience could pose major issues for your business. We recommend hiring staff members with at least two years of experience in medical billing, specific to to your organization’s specialty.

Identify and assign staff to be accountable for each stage of RCM and establish productivity goals

 

Designate specific team members to act as experts in each step of RCM to help with accountability. Studies have shown that employees perform better when they are held accountable for their roles and responsibilities.

Hold monthly meetings with your RCM team to analyze your key performance indicators (KPIs)

 

Understanding your business’ financial data allows you to create strategic targets and goals like net collection rate and high-risk accounts receivable. Many providers lack the technology to extract data that gives insight into their KPIs. Extracting the data from your EHR system is a key feature providers should look for when choosing their EHR provider. 

Successful revenue cycle management starts with measuring data effectively. Once you establish a data management program, you can organize information to measure various aspects of the revenue cycle process and more. With these insights, you can establish goals and benchmarks for employees and the business. 

Streamline patient collection 

 

Outstanding patient balances are a major revenue issue for practices. Many patients may have deductibles, coinsurances, or co-pays, which can lead to unrecovered revenue if your team can’t easily verify the patient’s responsibility. 

Systematic revenue cycle management programs can automate most parts of the eligibility verifications process. This stage of RCM can slow down or limit your collections if there is no automation process available. 

Analyze rejected claims and resolve internal issues immediately

 

After a claim is submitted, EHR platforms have claim scrubbing systems that prevent claims from going to the payer with errors. It’s important to understand this feature and proactively analyze their rejections. 

Rejections can be as simple as informational errors from improper record keeping or information transfer. Establish processes to resolve claim issues as quickly as possible — delays can cause further “timely filing” denials. Use an EHR system designed to assist with RCM

Carefully choose an EHR with built-in capabilities that streamline the RCM process.

 

Your EHR should assist with medical coding, identify root causes of claim rejections and manage patient eligibility checks. When deciding which EHR system to use ask yourself:

  1. Does the system have reports that are accessible in real-time to evaluate my performance?
  2. Do I have access to my data?
  3. Does the system have features that will enable me to enhance my reimbursements?
  4. What type of live support does the system offer?
  5. Where is the system’s team headquarters?
  6. How do I report issues I am having?
If your EHR doesn’t have all these features, is there a platform that provides them and integrates with your system?

What Can Gentem Do to Help You Improve RCM for Your Practice?

Gentem has multiple solutions with revenue cycle management improvement strategies. Our team of professionals is dedicated to your success and making sure our systems optimize your revenue cycle.

We support your business with medical coding services, claims denial and appeal management, advanced payments and tools that provide real-time eligibility.

a doctor talking to a Gentem representative about how to improve RCM

Our system can generate reports with key insights that are accessible in real-time to evaluate your performance. You’ll have instant access to your data, allowing you to find ways to maximize reimbursements with our advanced technology. 

We offer world-class support and a centralized ticketing system to track and resolve issues and questions. Learn more about our services and how we can improve your revenue cycle.

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5 Must-Know Metrics To Build A Thriving Medical Practice

With this free guide, you’ll learn the key metrics that inform your practice’s financial performance and how best to optimize them to support practice growth.

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