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Educating Practice Managers on Revenue Cycle Management

May 19, 2019

The revenue cycle management process, while standard in some ways, is always evolving, with new technology, new regulations, and new opportunities for growth. To stay efficient, practices may need to update their policies and procedures, as well as internal technology, to improve collection numbers and reduce bad debt.

Responsibility for these updates often falls to practice managers, who are uniquely positioned to identify internal issues and lead the charge for change. They could turn to healthcare consulting professionals for assistance, or they might simply do their own research to determine the best course of action.

Either way, even experienced practice managers can use a reminder on the foundations of revenue cycle management from time to time, particularly if that reminder also includes a newer take on how to manage revenue and patient interactions.

The medical industry has changed a lot in the last few years. In order to change with it, practice managers should review the following aspects of their revenue cycle management plan for ideas on how to get back to basics and improve overall outcomes regarding both financial goals and patient satisfaction.

Creating procedures for both front-end and back-end revenue collection.

Practices rely on funds from two main sources: the patients and insurance companies. While the whole list of processes necessary to gain funds from these two sources are far more complicated, they can essentially be broken down into front-end processes (i.e. things that can be done at the front desk or over the phone) and back-end processes (i.e. things that must be completed behind the scenes in the office).

This does not mean, of course, that all insurance processes are back-end and all customer-focused processes are for the front desk staff. In fact, front desk staff should be automatically verifying insurance eligibility prior to an appointment in order to advise the patient correctly of their out-of-pocket responsibility. Specialized software makes this process quick and easy. Most importantly, however, is that when these procedures are understood and clearly assigned, everyone can make sure their work is done better—and the revenue numbers will show the difference.

Taking the time to educate staff on their role in the process.

While practice managers certainly need to know their jobs, staff members also need a clear understanding of their part in the revenue cycle management process. This aspect is an area where healthcare consulting specialists can assist, or the practice manager can develop their own training program—but the fact is that there needs to be a training program for every incoming staff member to fully understand the work they’re doing and the impact it will have on the practice’s success.

According to Susan Dillery, a revenue cycle training specialist, “The first step toward developing an efficient, productive revenue cycle is attracting applicants and screening them to identify qualified candidates.”

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After finding the right people, it’s important to then provide those individuals with the training they need to be successful—and not in a “here’s a list of things to do today” kind of way. Staff members need to have a big picture view of how their work fits into the whole. Without this understanding, they are not empowered to help mitigate customer issues or avoid potential disasters. The more educated your staff, the more capable—and the fewer issues you’ll see in the long run.

Ensuring patients understand revenue collection processes and their responsibilities.

One of the most important aspects of the more modernized view of healthcare is working directly with the patient. This includes educating them on revenue cycle management matters. Some practices have even sought healthcare consulting professionals to help improve their ability to involve patients more with various aspects of the practice, but what it comes down to is simply taking the take to explain to patients about their options.

In this case, patients should know a bit about how their insurance coverage may affect certain health conditions as they arise. The more forewarning they have, the more they can prepare. Additionally, with high deductible plans on the rise, letting patients know ahead of time that payment plans are available could really benefit individuals who are scared of taking on more than they can handle. Sometimes patients will put off treatment simply out of fear of the cost.

To aid in revenue cycle management, especially in this age of easy and fast communication, let patients know about payment options with automated emails or notes to patient portals. This could also be something front desk staff remind patients to look up or ask about during appointment reminder calls. The options are available, and the patients will be happier for the knowledge—as will your bottom line.  

Plenty of practice managers do an exceptional job day in and day out—there’s no denying that. However, there’s always room for improvement or reconsideration, especially when the technology is changing drastically every day. Above are simply a few ways to make revenue cycle management a bit easier for everyone—in ways that get results towards your practice’s ultimate financial success.