The ACA has caused a steep increase in patient responsibility by way of higher co-pays and deductibles. These factors have become a bigger part of the revenue cycle and are a challenge for facilities to capture the additional costs.
Patients have become savvy consumers, comparing costs for services and selecting providers, clinics, and hospitals that yield the greatest result to the consumer. The ability to maximize their benefits, reducing their costs, while receiving the highest quality of care, is a driving force behind consumer healthcare decisions.
There is a lot of misinformation regarding the healthcare exchange and Revenue Cycle Management, and managers need to adjust the way their staff engages with patients. Staff processes continue to be the same as they were 5-10 years ago, but the landscape has extensively changed in an alarming way — organizations need to work hard to keep up.
Like any business, there is now consumer competition in the healthcare space. It is imperative to develop customer loyalty as you would in any other business. You do this by engaging your patients from intake and through the completion of the revenue cycle. Doing this will reduce your time to cash, improve your response rate and minimize the cost to collect. By communicating in a way that is transparent, you can create or modify the behaviors of your patients into one that is efficient to both parties.
Staff Communication – Synergy within the Revenue Cycle Team:
ICD-10 required most facilities to increase their training budget, as well as their staff size. Successful organizations started by reviewing provider documentation and educated physicians, in order to eliminate revenue cycle bottleneck. Online education allows physicians to audit and review documentation best practices in smaller chunks without having to sacrifice clinic or patient hours. Physician communication and engagement is integral to a healthy revenue cycle.
Create Revenue Cycle integrity by:
- Keeping open communication between denial management team and coding team.
- Understanding denials due to documentation and those due to coding.
- Preparing to work with payers to overturn denials.
- Building reporting to identify cash trends and make inpatient case by payer.
Revenue Cycle is a team sport and it is important that every player know and practice their role.