Optimizing Your Revenue Cycle Management in Healthcare

The COVID-19 pandemic presented a huge wave of difficulties for healthcare providers, many of which have lasting effects. It is hardly unexpected that similar difficulties were encountered by the revenue cycle. The revenue cycle experienced severe chaos as a result of the shutdown and transition to a largely virtual care environment. Billing and claims activities were drastically altered as a result of payer and governmental developments, and those working in the revenue cycle abruptly transitioned to almost entirely remote work. Budgets were also severely impacted as elective surgeries were suspended in order to concentrate on the escalating pandemic. In every medical provider practice, revenue cycle management (RCM) is one of the most crucial activities. Without a reliable RCM process, practices run the risk of losing out on reimbursement and suffering dangerous revenue declines.

What changes to practices' use of RCM should they be aware of in 2022? Let's look at a bunch of them.

Revenue cycle management issues

• RCM automation will just survive or succeed
  
  The RCM process has often been manual up until now in many clinics. But it's becoming abundantly clear that RCM automation is necessary for updating this procedure. Automation will make the difference between a practice that is just surviving and one that is thriving due to the complexity of payer rules, the variety of payers, and various means of care delivery, such as telehealth.
  
  Additionally, providers continue to face an increasing issue due to workforce shortages. One healthcare expert claims that automation can lessen the strain on collecting teams. Making the most of their scarce staff resources, particularly when it comes to patient collections, is a problem for providers. It's crucial to direct staff attention to the accounts with the highest likelihood of paying. This entails eliminating accounts that may be insolvent or defunct and employing automation to do manual activities like validating a charity's eligibility or organizing patient information. The best healthcare organizations are increasingly using automated calling and texting solutions to engage with patients and support understaffed employees in concentrating on the most important duties.


• Resource problems for remote workers
  
  Beginning in March 2020, COVID-19 broadened, and a number of significant changes in how we lived our lives followed. Work from home went from being an appealing idea to a necessity, and suddenly, many in the medical billing industry were working from their homes as well. It's true that doing so has helped to limit infection and given some people a higher sense of job satisfaction, but it hasn't come without its difficulties.


• Change the Payer to the Patient
  
  Patients are increasingly responsible for a larger portion of their healthcare expenses as high deductible health insurance policies have steadily become the norm. And there are no immediate plans to modify this. Unfortunately, some medical practices find it more challenging and frequently more difficult to collect patient payments than to file claims to payers. Because of this change, clinics must determine what obstacles there may be to receiving timely payments from patients and try to remove them. The use of eStatements and ePayments as solutions can significantly help with these problems.


• Increasing Risks to Data Security
  
  Cybercriminals have delivered an uncharacteristically hefty stomach hit to the healthcare industry. Data breaches are expensive, costing healthcare providers an estimated $7.13 million yearly and causing delays in patient care. To avoid the potential financial repercussions of a cyberattack, businesses must adopt a proactive approach to cybersecurity and minimize the likelihood of hostile activities.

Revenue cycle management is crucial

One of the most important procedures in a medical practice is RCM, therefore it's important to remain on top of the changes that might present possibilities and problems in the upcoming year. After the pandemic's unheard-of few years, certain changes are still in the works, and some trends from the last two years like more automation may very well stick around. Consider collaborating with a reliable third-party billing provider to assist handle these RCM issues and seize any possibilities if you want to be sure you're prepared for anything.