Healthcare News & Insights

Better, efficient revenue cycle management with patient centric approach

The pandemic has forced many healthcare stakeholders to seek out innovative tech solutions that improve their revenue cycle management, as the crisis continues to highlight the inefficiencies of an overly complicated (and often manual) process. After months of reducing activity and suspending elective procedures, healthcare facilities must reassess their business strategy with a focus towards improving operations.

While COVID-19 exposed many areas of inefficiencies over the past several months, many of these challenges have plagued practices long before the pandemic began. This is due to inadequate, siloed solutions that weren’t focused on minimizing patient liability during each step of the revenue cycle process. By focusing on front-end activities to reduce patient liability, practices can improve time to cash and reduce work required on the back-end.

This is especially important as healthcare facilities and labs are finding themselves processing a higher number of claims as they test and treat the virus, and as patients continue to utilize telehealth services in addition to returning to facilities for care. Since many patients have experienced changes in their employment status during this time, optimizing operational strategies from pre-visit to post care can assist facilities with containing costs throughout the pandemic. In order to do so, key stakeholders need to ensure successful reimbursement through an efficient, patient-centric revenue cycle management approach. This includes:

  • Patient estimation tools for improved financial transparency.
  • Fully integrated payment solutions that make it easier for patients to receive statements, pay their bill, and set-up payment plans in a timely manner.
  • Automated and integrated solutions that complete insurance eligibility checks, coverage discovery, and verification of benefits – which saves staff time and reduces the chance of a rejected claim.
  • Easing the burden of out-of-pocket expenses (i.e. large deductible plans, rising prescription costs, screening services, etc.) by investigating patient financing options.
  • Enhanced visibility into financial performance metrics – stakeholders can use to monitor, set priorities, and make better informed decisions.

By adopting a coordinated, patient-centric revenue cycle management approach, facilities can increase financial transparency and improve their operational efficiencies. This can strengthen contingency plans, minimize disruptions, and reduce patient liability during the reimbursement lifecycle of the patient.

For example, practices can reduce increases in aged receivables by enhancing pre-visit efforts through automated solutions. By performing eligibility checks and verification of benefits, patients can have a smoother financial experience since expectations have already been provided in a transparent, upfront manner. It is also critical to revise reimbursement plans at the time of service and leverage the use of integrated payment solutions to ease onsite payments and budget plans. Additionally, stakeholders should re-assess dunning messages and transfers for outside collection protocols.

While more patients are beginning to return to healthcare facilities, economic pressures will continue to weigh on patients and health care providers even after the pandemic has ended. By using a patient-centric revenue cycle management process, practices can enhance the patient experience and better manage their cashflow through improved operational efficiencies, reduced costs through automation of manual tasks, and increased financial transparency while operating during the pandemic and beyond.

Author: Teri Gatchel-Schmidt is the VP of consulting and business development at SYNERGEN Health.

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