Revenue cycle management (RCM) lies at the heart of a long-term post-acute care (LTPAC) provider’s operation. Without the proper processes in place, cash flow slows down, bad debt increases and customer satisfaction declines. So how can your LTPAC organization optimize its RCM function? We recommend starting with the five strategies outlined below.
1)Streamline Denial Management
Effective denial management is necessary to ensure that claims are processed in a correct and timely manner. It’s also crucial to helping ensure adequate cash flow. In order to be able to understand what a provider should be paid, monitoring and reviewing the current contracts with payers is necessary. Too often, payers underpay claims, deny too many claims or put unreasonable demands on the billing staff. It’s important to know your contract terms and responsibilities.
2)Utilize Benchmarks and KPIs
Not only does this help you make a plan, it helps you identify ways to improve your RCM process. By getting to the root-cause analysis, you can make improvements and measure your progress along the way. For example, are your claims being denied or being returned for incomplete information? Are you utilizing a triple-check process? What can be done to improve your LTPAC’s claims submission process for faster reimbursement?
3)Optimize Process Reviews and Compliance Audits
Your LTPAC should utilize a system that will help you to discover roadblocks in your RCM process and then help determine how to improve and implement change in your organization. Always ask the question, “How can we improve?” Managing your RCM process results in cleaner claims, faster reimbursement and satisfied patients.
4) Ask the Frontline Staff for Feedback
Your frontline staff is an invaluable resource for feedback, suggestions and potential risk areas. Listening to their concerns and recommendations, and integrating them into your RCM process, can help you to improve the culture of your organization. It also empowers employees to proactively offer ideas and suggestions that can help your LTPAC organization navigate the ever-changing health care environment.
5) Re-energize Your Organization’s Commitment to Customer Service
Health care in the U.S. is confusing and complex, to say the least. As a consumer, it is often difficult to know where to turn for guidance when there is a billing question or problem. It is our job to make the experience as efficient as possible and maintain a caring attitude. By doing so, you are far more likely to get correct and complete information from the patient, which results in a clean claim and faster reimbursement for the provider. That’s a win-win for everyone.