Achieving Excellence in Healthcare Revenue Cycle Management

The healthcare revenue cycle management is the financial circular system of any healthcare organization.. A wide array of technological and administrative processes is adopted by healthcare companies to ensure a smooth healthcare revenue management cycle. So what functions constitute a healthcare revenue management cycle and measures healthcare companies are taking to simplify the process?

A revenue cycle management includes evaluation, improvement and management of patient’s data and adoption of best practices that help simplify and speeding up the claim reimbursement cycle. The healthcare revenue cycle links seven different departments of a healthcare organization and efficient management, at all these different departmental levels can help healthcare organizations develop an excellent healthcare revenue cycle.

Some common activities that fall under the revenue management cycles are – patient registration; eligibility and authenticity validation; claim generation and application; medical coding; processing bills and payments;  Accounts receivable denial/follow-up management;  generating medical bills; charge capture; follow-up with patient and third party payments.

There are some measures that organizations can introduce at their firm that can aid in achieving a high quality healthcare revenue cycle management process

1) Establishing performance indicators at different department levels would help organizations monitor individual performance and productivity levels, against industry benchmarks for quality & quantity of throughput and speed with which targets are achieved.

2) Implementing appropriate organizational structure that facilitates increased collaboration among different departments and ensures consistent performance expectations from different departments can help in better management of the overall revenue cycle.

3) Revisiting and redesigning workflow processes that require improvement can also aid in improving the quality of overall healthcare revenue cycle management. Departmental level performance indicators can help in quickly identifying areas with scope for improvement. Restructuring these low performance areas using best healthcare practices would help in removing redundancy and improving efficiency in management of revenue cycle.

Healthcare companies regularly face the challenge of escalating healthcare costs. A quick and resource productive healthcare revenue cycle management would help healthcare organizations rein in escalating costs.