Best Practices for a Successful Revenue Cycle Management


There is no denying the fact that revenue cycle management plays an important role in the success of any medical practice. With most practices finding it hard to generate better revenues, thanks to delayed and rejected claims, this has become all the more important. According to experts, most medical practices lose out on about 30% of their revenues due to various issues. However, implementing a few efficient Revenue Cycle Management practices can help in overcoming these glitches and thereby enhance the profitability of any practice.

Given below are a few such practices that are sure to optimize the collections and thus improve the revenue cycle.

Say No to Denials:

It is very important to avoid denial of claims as this leads to accumulation of debts and increased expenses. In fact, all medical practices and health care providers should come up with an efficient technique that would help them to manage the denials and make quick appeals for the claims to be settled. Practices which are unable to manage denials end up losing a lot of revenue which can actually have a direct impact on their financial position.
In order to avoid this, medical practices should actually come up with a plan that will help them to reduce the number of denials. The first step for this is to identify the reason for these denials. Once this comes to the fore, the medical staff can ensure that these errors are not repeated. Also practices should become smarter and make sure that the claims are verified on a regular basis and quick action is taken in case of denials and underpayments.

Daily Claims Submission:

By submitting the claims on a regular basis, medical practices can ensure a steady in flow of revenues. This also makes it easier for them to handle the claims in a much more efficient and effective manner.

Taking Note of the Current Management Workflow:

Another important practice that should be implemented in every medical facility to improve the revenue management cycle is to conduct a close examination of the current workflow and check out its efficiency as well as problem areas. By doing this, the practices can actually understand where they are lacking and can come up with plans to improve their workflow.

Reviewing the Codes:

A regular review of the coding by the medical practices would help them ascertain whether it is up to date and in sync with the latest regulations. It should be noted that many a times, outdated codes could also be a reason for increased number of denials.

Analyzing Payments:

Analyzing the financial capability of the patients can help in finding out the revenue generating ability of any practice. According to experts, it is a good idea to conduct a financial clearance of a patient at the time of booking of the appointment. This would help in collecting the details of the insurance coverage of the patient, the services for which he is eligible, financial responsibility etc. It is also important that constant reminders are sent to the patients to settle their outstanding bills. One of the best ways to increase cash flow and reduce the expenses in a practice is to collect the payments at the time the service is offered.

Management of Accounts Receivable:

Practices can improve their financial performance with an efficient AR management system in tow as this ensures a recovery of at least 60% to 70% of the denied claims.

It is extremely important to keep track of the claims and not let them accumulate. An effective follow up of denied and delayed claims also helps in improving the whole Revenue Cycle Management. By incorporating the aforesaid practices into a medical health care process, every medical practice can look forward to improved revenues.