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Keys To Improving Your Revenue Cycle – Food, Drugs, Healthcare, Life Sciences


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Keys To Improving Your Revenue Cycle

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Revenue cycle management (RCM) is one of the most complex
medical office tasks. There are layers of steps involved in the
process and roadblocks may be encountered throughout the entire
process. Luckily, there are ways to apply the standard principles
of professional RCM to improve your office’s ability to get
paid in a timely manner.

Related Read: How’s Your Revenue Cycle?

Here are five ways to help evaluate your RCM:

  1. Utilize the Entire Team
    Everyone in the practice plays a vital role in the
    successful submission of insurance claims. The process really
    starts the moment the patient calls the office. Obtaining the
    patient information, processing insurance cards and documenting all
    necessary information can and should be performed before the
    medical professionals even see the patient.

  2. Avoid Rejection
    About a third of claims are rejected over eligibility
    issues. However, utilizing the available technology can minimize
    and even eliminate this issue. Your electronic health record (EHR)
    system should have this capability. Eliminate this problem on the
    front end to allow for successful payment on the back end.

  3. Keep the Patients
    It is very uncommon for patients to be fully aware of the
    details of their policy and what may or may not be covered. It is
    important that your practice educates and informs patients of what
    patients owe and when. Communicate possible co-pays or other costs
    a patient may be liable for early on.

  4. Perform Internal Audits
    Quite often revenue is lost merely from the fact that
    billing never went out. It is best practice to examine this at
    least twice a year through an internal audit. Questions to consider

    • Are services being paid on

    • Do the services match the
      patient’s explanation of benefits?

    • Are the write-offs being applied
      appropriately and the balances corrected as necessary?

  5. File Claims on Time
    Some funding sources have expiration dates of when claims
    can be filed. Do not miss a filing deadline as this will
    automatically create a loss of revenue. Evaluate and monitor the
    time each step takes, from the time the patient attends the
    appointment to the moment the claim is submitted, posted and

Getting the most out of your revenue cycle is incredibly
important. Identify where issues may arise. Being proactive is the
key to obtaining your maximum potential. Do not miss out on lost
revenues, especially if you put in all of the work already.

Related Read: Help Your Bottom Line: Focus on Your Revenue

The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.

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