Why Is Revenue Cycle Management Important in Healthcare?

Revenue cycle management helps your practice maximize reimbursement and get paid faster. When your healthcare practice’s finances are in order, you can invest more in your core mission — your patients’ health. Here is why high-quality revenue cycle management is important in healthcare.

Revenue Cycle Management Improves the Patient Experience

Revenue cycle management in healthcare begins when a patient makes an appointment. Collecting accurate, complete patient information, including accurate insurance coverage, ensures your practice can be paid for the services you perform. Your EHR and EPM system can check eligibility and help you get any needed authorizations before the patient arrives at your office. By streamlining data collection and insurance authorization, you can reduce patients’ administrative burden and improve the patient experience.

Tools like NextGen’s Patient Portal (formerly Medfusion) can further enhance the patient experience while boosting your revenue cycle. Using in-office kiosks, patients can check themselves in for appointments and verify their insurance information, reducing claim denials. You can also give patients multiple ways to pay, including online, to improve the collection of copayments and deductibles. Studies have found that tools like cost estimators and online bill pay improve satisfaction. These tools also improve your revenue cycle by reducing the need to prepare patient statements to collect copays or deductibles.

Revenue Cycle Management Can Reduce Administrative Burdens

Well run revenue cycle management teams do not just reduce administrative burdens on patients, they also reduce burdens on providers and staff. A strong revenue cycle management process builds medical coding and documentation into office visits workflows. By capturing billing data during patient encounters, providers can reduce paperwork after visits. EHR prompts can also remind providers to complete documentation or add missing codes. These alerts free providers from keeping track of varying insurance requirements.

EHR prompts for coding and documentation requirements can also reduce burdens on your billing staff. When your medical billing specialists receive complete data from providers, they do not need to spend time adjusting coding and verifying the services and procedures provided during an office visit. Strong revenue cycle management procedures help billing specialists with charge capture, minimize claim lag, and maximize your revenue without adding burdens to your providers.

Revenue Cycle Management Helps Your Practice Get Paid More, Faster

Revenue cycle management can help your practice maximize reimbursement and minimize accounts receivable aging. With automated billing processes and built-in accuracy checks, your medical billing processes can prepare and scrub claims more quickly. Your EHR and EPM system also lets you submit claims electronically, saving time and money. The integrated EHR and practice management billing system can automatically create electronic claim files and upload them to your claims processing clearinghouse each night, saving your billers from manual intervention. Your clearinghouse can also automate the downloading of ERAs for batch posting. This means your medical billing specialists do not need to check in on posting and can instead focus on working complex claims, resubmitting denied claims, or following up on accounts receivable.

By submitting clean, scrubbed electronic claims, you can reduce denials and speed reimbursement. You can also use tools like TempDev’s Revenue Cycle Dashboard NextGen EPM Report to help you keep track of your accounts receivable and resolve problems. Accounts receivable days in aging should be kept to 50 days or less, with 30-40 days an ideal target. If you have payers or patients with A/R exceeding 60 days, your medical billing specialists should follow up to resolve any issues.

Revenue Cycle Management Reduces Claims Denials

Claim denials happen, even with robust processes to verify patient information, gather coding and documentation, and scrub claims. But your practice can work to minimize them and to put processes in place to resubmit denied claims quickly. Revenue cycle management helps you lower the share of claims that are denied, saving your practice time and money.

You can minimize claim denials by investigating past denials to look for patterns. For example, TempDev’s Revenue Cycle Dashboard NextGen EPM Report lets you see your denied claims by reason for the denial in one place. This can help your practice identify the top reasons for denied claims and address them with workflow redesign, custom templates, or training. 

With strong revenue cycle management, you can also resubmit denied claims quickly to help maximize reimbursement. By one estimate, up to 50% of denied claims are never resubmitted. By automating simple billing processes and improving your coding and documentation, you can ensure your billers have time to focus on working denied claims for timely resubmission.

Revenue Cycle Management Prepares Your Practice for Financial Reporting and Audits

Financial reporting and audits can feel like a burden for practices. But your revenue cycle management processes can prepare you to tackle these requirements with ease. The processes you put in place to document and code visits, scrub claims, and track accounts receivable ensure that you have accurate data on your payments, adjustments, and revenue. By integrating your EHR and EPM system with your general ledger system, you can transfer financial data seamlessly. This helps your practice prepare financial statements and submit to audits with minimal extra work from your billing and accounting teams.

How TempDev Can Help with Revenue Cycle Management

TempDev’s NextGen consultants, trainers, and developers can help you boost your revenue cycle management. From revenue cycle consulting and dashboards to automation and workflow redesign, TempDev can give you the tools you need to improve your practice’s financial picture. Through TempBill, you can also outsource or co-source medical billing or get in-house temporary billing support.

Call us at 888.TEMP.DEV or contact us here to get help with revenue cycle management in healthcare.