7 Best Practices for Revenue Cycle Management

• Streamline Patient Registration and Eligibility Verification

Efficient revenue cycle management starts with accurate and streamlined patient registration. Implementing electronic registration systems and online patient portals can significantly reduce data entry errors and improve data quality. 60 percent of provider respondents believe that the electronic medical record plays either an extremely critical role (27 percent) or a very critical role (33 percent) in managing their organizations’ revenue cycle. Enabling operational interoperability with EHRs improves patient registration and scheduling workflows enabling real-time omnichannel access to patient records. Automating insurance eligibility verification processes can also minimize denials and reduce administrative burden. By ensuring accurate and up-to-date patient information, organizations can avoid claim rejections and delays, ultimately improving cash flow and revenue realization.

• Leverage Artificial Intelligence (AI) and Machine Learning

Artificial Intelligence (AI) and Machine Learning (ML) are revolutionizing the healthcare industry, and their applications in revenue cycle management are no exception. AI and ML algorithms can analyze vast amounts of data to identify patterns and trends, optimize coding and documentation, predict claim denials, and automate repetitive tasks. These technologies have the potential to enhance revenue cycle efficiency, reduce errors, and improve reimbursement accuracy.

• Prioritize Patient Financial Responsibility

With the increasing prevalence of high-deductible health plans and rising out-of-pocket costs for patients, healthcare organizations are focusing more on patient financial responsibility and offering compliant bill payment options. In 2023, it is essential for organizations to improve patient communication and education regarding financial obligations. Providing accurate cost estimates, offering flexible payment options, and implementing tools for real-time benefit verification can help patients make informed decisions and improve revenue collection.

• Offer Value-Based Care and Alternative Payment Models

The shift from fee-for-service to value-based care models continues to transform the healthcare landscape. In 2023, healthcare organizations will increasingly participate in alternative payment models, such as accountable care organizations (ACOs) and bundled payment arrangements. These models emphasize quality outcomes and cost savings, necessitating changes in revenue cycle management. Organizations must focus on accurately measuring and reporting quality metrics, negotiating value-based contracts, and aligning reimbursement with patient outcomes.

• Focus on a Patient-Centric Approach

By prioritizing patient needs and satisfaction, organizations can enhance the overall patient experience, leading to increased patient loyalty and improved payment collection. 37% of patients said poor patient-centered billing and payment confusion left them paying bills late and with a poor financial experience. A patient-centric approach involves clear and transparent communication regarding financial responsibilities, providing accurate cost estimates, and offering flexible payment options. When patients feel well-informed and supported throughout the billing process, they are more likely to pay their bills promptly, reducing accounts receivable. Moreover, a positive patient experience fosters patient trust and enhances the organization’s reputation, attracting new patients and promoting patient retention.

• Improve Intelligent Workflow Automation

By automating repetitive and manual tasks such as claim submissions, payment posting, and follow-up activities, workflow automation reduces the risk of errors, enhances efficiency, and accelerates revenue collection. Automation tools can integrate with existing systems, such as electronic health records (EHR) and billing software, to facilitate seamless data flow and eliminate the need for manual data entry. This not only improves accuracy but also frees up staff time, allowing them to focus on more complex and value-added tasks. Additionally, workflow automation provides real-time visibility into revenue cycle performance, enabling organizations to identify bottlenecks, track key metrics, and make data-driven decisions to optimize processes.

• Simplify Patient Access

Organizations streamlining the process of patient registration, scheduling, and eligibility verification can reduce administrative errors, enhance operational efficiency, and expedite revenue collection. Simplified patient access includes implementing user-friendly online portals and appointment booking systems, allowing patients to easily schedule appointments and access their health information. Moreover, providing multiple channels for patient communication and offering self-service options for tasks like updating personal information and making payments empower patients to actively engage in their care and financial responsibilities.