Revenue Cycle Management Case Study

714 Words3 Pages
Common mistakes regarding the revenue cycle that should be avoided at all costs.

Recently, Revenue Cycle Management for healthcare service has gained a lot of popularity. And rightly so. With the increasing number of patients and practices, managing a healthcare facility needs to be done systematically. And what better than using the tried and tested tools of business management?
However, the success of your healthcare service depends largely upon the ability to compete in the market. And for competition, you need to manage revenue. Revenue Cycle Management is gaining a lot of popularity due to its numerous benefits. But, there are still many misconceptions and mistakes that healthcare services make which results in a direct impact on their
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RCM complicates the healthcare service.
This one is probably the biggest mistake a physician makes. RCM was designed to help an organization, not complicate it. Moreover, there are means of outsourcing RCM, which will lessen the burden on the healthcare service, at the same time, bring in experts to handle the revenue cycle, which of course, will have its own benefits.

3. Collection.
It has been observed that numerous healthcare services do not collect at the Point of Service. This makes things difficult for the practice. Avoiding this often puts the revenue cycle at risk since co-pay and reimbursements are a major chunk of you and your staff’s income.

4. Submitting Claims.
Most practices submit claims on a weekly basis. A weekly submission increases the chances of the claim getting lost before submission. Moreover, it will also result in delayed payments and increased turnaround times. Submitting claims daily is a good practice. It ensures that all claims are successfully submitted. Moreover, you have the option of automating the submission which will reduce the time and effort required from your end.

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Many also forget to check the patient’s co-pay arrangements with the insurance company. Ineligible patients, if treated, could result in a lot of delayed payments and your revenue cycle will be compromised. Moreover, you will have to spend more time and resources to collect those outstanding payments. There might also be situations wherein you will have to write-off a certain debt.

7. Trend monitoring.
With the adoption of Revenue Cycle Management, there are huge amounts of data available to the practice. Monitoring this data weekly will help understand the trends during the week and necessary changes can be made in the practice to accommodate patient requirements. After a while, with adequate data, you can predict trends as well, which will prove helpful to your healthcare service.

The above mentioned mistakes are common for most practices. However, all is not lost. Now that you know what to do, you can get your Revenue Cycle back on track in no time. The simplest way to enhance and optimize your Revenue Cycle is to partner with some organization that provides RCM services. This not only saves you the time and resources, but companies that undertake such contracts have experts who can help enhance and further optimize your
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