How to Manage Your Health Facility’s Revenue Cycle Post Pandemic

By RMK HOLDINGS INC. | May 10, 2021 | 0 Comments

At the height of the coronavirus pandemic, health facilities like yours were overwhelmed and had to choose their battle carefully. Things like checkups and elective surgery were shut down, and there wasn’t time to properly manage the revenue cycle. This led to most facilities, and probably yours too, experiencing a drop in revenue by up to 50%. But, how did COVID-19 affect revenue cycle management to this extent?

How the Pandemic Impacted Health Revenue Cycle Management

During the lockdown that started last April, non-essential health workers, such as health insurance companies, had to work from home. This meant that revenue cycle management was handled remotely, and things didn’t run as smoothly if prior processes were lax. or outdated What’s more, health facility workers’ resources were spread even more thin and diligent claims follow up probably didn’t happen.  

Secondly, medical facilities lost employees in charge of revenue cycle management, either to death or other facilities. Beyond the loss of manpower, for some facilities, it also resulted in the new recruit having difficulty managing the revenue cycle, as there wasn’t proper documentation of the management process. Furthermore, because everything was on lockdown, recruitment of new personnel was difficult, and perhaps there was no feasible infrastructure for online training.

Lastly, facilities that were making efforts to stay on top of their revenue cycle management paid more attention to the front end of the revenue cycle. They carried out quality assurance and random audits to ensure that claims are coded and appropriately documented. But, there wasn’t enough effort on the backend to resolve issues like denied claims, no-response claims, partially-paid claims and underpaid claims. 

Here are six tips to regain control and stay on top: 

  • Submit Claims Fast

Claims shouldn’t be sent after a week or more after the medical service is rendered. Ensure that they are sent out immediately, or within 48 hours at most. Also, avoid lags in the processing of denied and underpaid claims. Follow up with insurance companies quickly to resolve medical claims with any issue, before they become old AR that you would eventually write-off.

  • Promote a Qualified Existing Individual or Hire a Practice Administrator

A practice administrator who can assimilate the practice data along with your revenue cycle data can further streamline your practice, resulting in a smoother and more efficient running healthcare business. If you’re not large enough to hire a practice administrator, then employ someone whose sole job will be to manage and review your revenue cycle numbers and resolve bottlenecks before they affect revenue turnaround. 

  • Create SOP Documentation

Don’t just let vital information about your revenue cycle be only in your current staff’s head. Ensure that you have standard operating procedure (SOP) documentation for every step of your revenue cycle management. This will put things in good order, so whoever fills the position can manage your revenue cycle effectively. Also, have an excellent recruitment and training infrastructure in place, so you can easily recruit and train new staff. There’s a reason businesses like a popular coffee shop have detailed written and visual training materials – because it works.  

  • Use the Proper Tools for the Task at Hand

Ensure that the tools needed to process and report your revenue cycle data are available. With the right tools in place, reporting will be done quickly and adequately. You would also be able to spot trends in your facility, as well as measure data and get insights to take action. If a standard report doesn’t capture the exact data you want to track, reach out to your software vendor for training or development of custom reporting tools. The upfront investment could save you hundreds in months to come.  

  • Convert Physical Checks to e-Images

Many checks are forgotten in drawers and never make it to the bank – it’s hard to fathom but it happens. Some even get lost or damaged. Not to mention, it isn’t efficient to wait until checks are deposited into the bank weekly to process the payment. So, speak with your banking partner about setting up a lockbox service to scan and convert checks to electronic images the day they come in. Your payment staff can then retrieve the images and post to accounts immediately. Reconciliation reporting is handled by matching what is posted to the day’s electronic e-payment images.  

  • Outsource Your Revenue Cycle Management 

You shouldn’t be managing your revenue cycle management yourself nor rely on non-trained medical staff to do so. And, perhaps your back office staff splits their time between other responsibilities and the accounts management area. This means the revenue cycle probably isn’t running as smoothly or capturing lost claims quickly. Stop leaving a third or more of your lost revenue on the table. To get back on track, close open balances quicker and increase patient contact, reach out to us to manage your health facility’s revenue cycle efficiently.

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