7 Ways to Improve Your Healthcare Revenue Cycle Management

Your practice’s finances depend on strong revenue cycle management processes. Here are seven tips to help your practice improve its healthcare revenue cycle management processes and your overall financial health.

Tip #1: Analyze Your Denials and Identify Your Problem Areas

Your practice management system is a powerful tool to help improve your revenue cycle management. For example, NextGen EPM can help you assess denied claims to identify patterns and process improvements to reduce denial rates.

Tools like TempDev’s Revenue Cycle Dashboard NextGen EPM Report show you an overview of your denied claims all in one place. With this data, you can identify the common reasons for denied claims, including lack of documentation, missing or incomplete information, or non-covered services. You can then target training, workflow redesign, and automation to address the reasons for frequent claim denials. By addressing the root of the problem, you can prevent future denials and save your practice time and money.

Tip #2: Automate Insurance Eligibility Checking

Insurance changes happen frequently. If your practice does not check and update patients’ insurance information before each visit, you may end up with costly denied claims. It is critical to run insurance eligibility checking prior to a patient coming in for an appointment Tools like NextGen’s Patient Portal (formerly Medfusion) let patients update their information directly, saving your front desk staff time. You can also pair your EHR and EPM system with check-in kiosks to ensure patients double-check their insurance and other information in the waiting room before their visit.

Covered services, patient cost-sharing liability, and billing preferences also differ across payers. You can pre-populate your NextGen system with information for common payers to help providers avoid coding errors. Your EHR and EPM can also automatically check patients’ insurance coverage to ensure your providers prescribe covered medications in their formulary and refer to specialists in-network.

Tip #3: Build a Robust Claim Library to Ensure Clean Claims

With an integrated EHR and practice management billing system you can get claims to payers faster than ever before. Through the usage of a robust claim library that you build over time based on your common denials that intercept charges before they go to your clearinghouse, you can lessen your denial rate even more. This library of business rules serves as a template for building clean claims for future encounters. You can use your claim library to automate billing for common claims to common payers. You can also double-check billing against your claim library to ensure accuracy. A claim library helps your medical billing specialists create and submit clean claims by giving them templates against which to check their work. It also ensures that your physicians don't have to be coding experts and can bill codes through the EHR, have them checked through your claim library and either stopped or automatically fixed, and then delivered to your clearinghouse with very little biller intervention.

Tip #4: Automate Routine Billing Processes

An EHR and EPM system can reduce data entry and data duplication, both of which are common sources of errors. You can also automate simple billing tasks, such as creating 837 files and uploading them to your clearinghouse. By automating your practice’s simple billing tasks, you free up your medical billing specialists to focus on complex claims, and work on delayed and denied claims, improving workflows and processes to speed reimbursement.

Third-party revenue cycle consultants like TempDev can help your practice with billing automation. TempDev’s consultants can work with your medical billing specialists to identify which tasks to automate and build workflows to maximize billing efficiency. Plus, TempDev’s developers can create the NextGen code to achieve your vision, and trainers can ensure all staff members know how to use your automated processes.

Tip #5: Automate Posting

With automated electronic remittance advice (ERA) posting, your billing staff will not need to check for posted payments, adjustments, and denials. This critical claims information, as well as EFT payments, can automatically transmit to your EHR and EPM system. Tools like NextGen Background Business Processor (BBP) can automate posting and free your billing staff from tracking down adjustments and denials. Instead, your staff can concentrate on accounts receivable follow-up and other tasks to improve your revenue cycle.

Tip #6: Perform Contract Analysis

Healthcare practices often overlook contracts with payers when seeking to improve revenue cycle management. But payer contracts can include details beyond payment rates that affect your bottom line. This includes the amount of time your practice has to submit bills, the amount of time the payer has to pay claims, denial dispute procedures, and details of covered services. By performing contract analysis, you can identify areas for improvement in your billing processes to get paid more reliably and faster by key payers. However, the most crucial part of contract analysis generally comes to payment amounts. It is important that your practice understands what you're supposed to be being paid by payers and ensure you are being paid that amount. NextGen EPM Contract Analysis report helps granularly but most practices struggle to build a consistent routine to regularly negotiate with payers on incorrect payments. TempDev has worked with many practices to establish processes that work and regularly bring in additional owed revenue to practices.

Tip #7: Give Patients Multiple Ways to Pay

Surveys show that patients want convenient ways to pay their bills. Your practice may be able to clear patient balances more quickly if you expand your payment options to include electronic payments. Tools like NextGen’s Patient Portal (formerly Medfusion) allow patients to pay bills online at their convenience. Other tools like text reminders to pay bills have commonly been deployed to remind patients of payments.

How TempDev Can Help Your Practice Improve Its Healthcare Revenue Cycle Management

TempDev’s NextGen practice management consultants can help you improve your revenue cycle management with workflow redesign, dashboards and reports; training; and automated billing processes. If your practice suffers from claims denials, slow payment, or other revenue cycle issues, TempDev stands ready to help you find a solution.

Call us at 1-888-TEMP-DEV or contact us here to learn more about how you can improve your healthcare revenue cycle management.