Improving revenue cycle health can help keep your practice financially healthy, letting you continue to provide high-quality care to your patients. But many practices struggle to improve revenue cycle health on their own. Here are four key barriers to improving revenue cycle health and how your practice can address them.
1. Your Workflows May Be a Barrier to Revenue Cycle Health Improvement
A workflow is a process your practice uses to complete a task. Revenue cycle health depends on several key workflows in your practice. Office visit workflows, including check-in procedures, can be a hidden barrier to improving revenue cycle health.
If your practice only focuses on medical billing and payment posting, you are missing opportunities to maximize your revenue cycle. Upstream investment in your check-in and office visit workflows can pay dividends in fewer denied claims, faster payments, and less accounts in bad debt.
Office visit check-in processes can be a barrier to improving revenue cycle health because outdated or inaccurate insurance information can cause claims denials, as can failure to obtain prior authorization. Your check-in processes should include insurance coverage and eligibility verification. Your EPM (enterprise practice management) system can automatically help your staff complete eligibility checks, simplifying processes. Your practice can also use kiosks, tablets, and other tools to let patients update their information directly in your practice management system. Using these tools for check-in eliminates the need for data entry and reduces the likelihood of errors.
Adding tools like NextGen Patient Portal (formerly Medfusion) can also help with revenue cycle health improvement. With the NextGen Patient Portal, patients can update or verify their insurance information, get cost estimates, and pay any cost-sharing before their appointment, expediting the check-in process. It also makes it easier for patients to pay their copays and deductibles, which helps to reduce bad debt.
Office Visit Workflows
Office visits generate the diagnosis and procedure codes your medical billing staff needs to submit claims. But many practices do not have office visit workflows that incorporate coding and documentation into every visit. If coding and documentation are treated as after-visit or after-hours tasks for providers, your practice risks gathering incomplete data and burning out care providers.
Workflow redesign can help your practice integrate coding and documentation into your office visit workflows. A formal workflow redesign process will let your practice examine problems in your current workflows, build consensus on how to address those problems, and develop and test new processes. If you include providers in the process and offer robust training, you can streamline workflows, improve revenue cycle health, and improve satisfaction with your EHR system all at once.
2. Your EPM System Configuration Can Impede Revenue Cycle Health Improvement
Your EPM system can be a powerful tool to support revenue cycle health improvement. But if it is not configured properly for your needs, the data can become overwhelming. Dashboards and reports can help your practice make sense of your revenue cycle without the need for in-house data analysts. For example, TempDev’s Revenue Cycle Dashboard NextGen EPM Report can show you your accounts receivable aging, payments by payer, and denial statistics by reason for the denial. Having all of your practice's data in one place will help your practice to identify revenue cycle problems and correct them.
You can also configure your EHR and EPM systems to automate simple billing and payment posting tasks. For example, you can use NextGen’s Background Business Processor to automate tasks that would normally require direct staff input. Your practice can then run those tasks overnight to avoid overwhelming your staff and production system. The NextGen BBP can complete tasks such as:
- Running claim edits, scrubbing claims, and flagging possible errors prior to submission to the clearinghouse
- Batching and submitting electronic claims to your practice’s clearinghouse
- Downloading ERA files from your clearinghouse
- Importing payments and adjustments from ERA files into your EHR and EPM systems
3. Improving Revenue Cycle Health Requires Resources
Improving revenue cycle health can seem daunting for medical practices. With limited staff and resources, it can be difficult to devote time to identifying revenue cycle problems and fixing them. If your practice is struggling to find the time to address your revenue cycle, you may need external support.
Services like TempDev’s TempBill team can work with your practice to support revenue cycle improvements, special projects, or ongoing medical billing needs. Temporary support from on-site consultants or medical billers, or long-term staff augmentation, can help your practice improve revenue cycle health.
4. Improving Revenue Cycle Health May Require Staffing Changes and Training
Your staff is the cornerstone of your revenue cycle. If your providers and staff do not know how to use your EHR and EPM systems to generate clean, accurate claims, your revenue cycle will suffer.
A strong revenue cycle starts with highly qualified medical billing specialists. Trained medical billers can handle a high volume of claims while also keeping an eye out for recurring problems and areas for improvement. If your medical billing department is understaffed or underperforming, services like TempDev’s TempBill can help. Whether you need staff augmentation, training, or system configuration, a third-party consultancy like TempDev can help your medical billing department get back on track.
Providers and front-desk staff can also inadvertently hinder revenue cycle health improvement. If your practice struggles to collect cost-sharing or frequently has claims denied for errors or missing documentation, training might help. Training can shore up your providers’ and staffs’ confidence with your EHR and EPM systems. You can also conduct workflow training to ensure all staff members have the necessary information to complete key tasks.
How TempDev Can Help With Revenue Cycle Health Improvement
TempDev and TempBill can help your practice overcome revenue cycle health improvement barriers. TempDev’s systems analysts can automate simple billing and posting processes to save you time, and our consultants can help redesign your workflows to minimize claims denials and delayed payments. Plus, TempBill’s expert medical billing specialists can work with your office to fill in for absences, augment your staff, or help with special projects.
Schedule a consultation with TempDev today. Call us at 888.TEMP.DEV or contact us here to get started improving revenue cycle health.
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