Slideshow 8 steps to improve revenue cycle management

  • June 23 2016, 6:23am EDT
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8 steps to improve revenue cycle management

Workflow adjustments, software capabilities can improve billing efficiency.

Collect upfront and automate more tasks

To improve revenue cycle processes, healthcare organizations must focus efforts on steps that will produce the biggest payoffs; process changes and new information technology tools can automate tasks and thus may help providers gain efficiencies, according to revenue cycle software vendor ZirMed. Here are some of the top areas for improvement, it says.

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Use electronic eligibility verification

Don’t saddle the claims staff with calling, faxing and visiting multiple payer web sites to confirm whether a patient has insurance coverage and the level of coverage. An organization can gain efficiency by using a single eligibility verification system to confirm coverage from all insurers.

Take advantage of coding tools

An organization should use a set of automated coding tools that integrate with claims software, is regularly updated and enables staff to search specific subsets of codes relevant to the organization.

Improve handling of denials and appeals

Software that manages denials and appeals should do most of the work an organization. It should automatically provide payer-specific paperwork, then auto-populate, print and mail the completed appeals. The application should be able to track appeal effectiveness and denial trends among payers.

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Restructure workflows

Money that an organization collects from patients before services are provided avoid post-service expenses, such as billing, collections or bad debt writeoffs. Organizations need to ensure that they have restructured workflows to collect copayments from patients when staff is checking insurance coverage. Patient estimation software can predict a patient’s total financial responsibility based on demographic, insurance, encounter and procedure information. Estimation software should use an organization’s fee schedule and chargemaster data.

Cut the paper cord

Switching from paper to electronic statements cuts the mean days to payment from 20 to 9, while boosting the percentage of full payments rendered from 77 percent to 95 percent, ZirMed estimates. But organizations shouldn’t just rely on e-statements; they need to find a system that will automatically generate and mail a paper statement if the patient doesn’t react to the electronic statement within a reasonable period of time.

Offer a portal

Use color in bills to highlight key points, including how much is owed, what services are being billed and how to pay. Make it easy to pay with a patient portal where patients can manage and pay bills, access billing records and check payment status from any Internet-connected device. A well-designed portal can increase patient loyalty, improve collections and save staff hours of “phone tag.”

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Use features you paid for

Organization often overlook automated features they already have in their current software. For example, if a provider is still posting and reconciling remit, payment and deposit records manually, look for an application in the software that will do it automatically.

Upgrade lockbox capabilities

Consider virtual lockbox services that handle checks from insurers and patients. Incoming checks go to the lockbox and are automatically imaged, converted into electronic payments, and processed and deposited on an organization’s behalf.

Learn more

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