Knowledge Expansion

Revenue Cycle Management: The Secret Sauce

Insight Article

Billing & Collections

Kenneth T. Hertz FACMPE
I’ll offer the bad news first: There really is no “secret sauce.” The good news is that even though there is no secret sauce, you can improve your revenue cycle management and it’s not as hard as we make it!

Here are four tips to improve your revenue cycle management:

1. Measure. The saying goes, you can’t improve what you don’t measure. Know where you are today and how effective you are in each segment of the revenue cycle. Establish key performance indicators (KPIs) and assess your performance against them on a monthly basis. Share results with your team, establish performance goals and recognize achievement.

2. Train. Train and educate your entire revenue cycle team. Ensure that each person understands both his or her role in the overall cycle as well as how everything that he or she does has a consequence somewhere else in the cycle. Train your operators, check-in and check-out staff, nursing staff and billing and collection staff on the importance of coding and documenting work. Train and educate the team on the system, the payers, rules and regulations and the changing plans (high-deductible plans). Provide the appropriate tools and resources for your team to research questions and address issues. Ensure that those tasked with asking for payments know how to ask properly and feel comfortable in that role. If they do not, make a change.

3. Technology. Select the right technology. Leverage the technology. Embrace the patient portal, kiosk registration, real-time adjudication and other solutions that will support your team in working smarter, not harder. Utilize secure encrypted text messaging and emails for patient communication and patient reminders.

4. Follow-up. It seems obvious, but it’s not. Follow-up with payers. Address denials, rejections and requests for additional information. Do not drop the ball. If you do, you’re leaving money on the table. Follow up with providers. Ensure that the team communicates coding or documentation issues with providers to mitigate future issues. If not, you’re leaving money on the table. Follow-up with the staff. Let them know how they are doing. What is working, and what isn’t? Follow up on patient balances. Work those balances. Now, not later. If not, you’re leaving money on the table.

Is this all that different than what we have done in the past? Perhaps not, although there is more emphasis on leveraging technology.

Revenue cycle management is not for the faint of heart. It requires attention to detail, rigorous discipline, compulsive follow-up and the embracing of technology. It also requires a commitment to training and educating staff as well as patients in the technology available to us. It seems hard. But, it doesn’t have to be as difficult as we tend to make it.

If you are interested in learning more about how to evaluate your revenue cycle and discuss opportunities to improve your practice, please contact Ken Hertz at khertz@mgma.com.

About the Author

Kenneth T. Hertz
Kenneth T. Hertz FACMPE
Consultant MGMA Consulting

With nearly 40 years of management experience, Kenneth T. Hertz, FACMPE, has held numerous leadership positions in small and large healthcare organizations in primary care, multispecialty care and large integrated systems. His consulting work has encompassed a broad range of services, including operational improvement, practice analysis, strategic planning, organizational development and strategic marketing.

Loading...