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Getting Back to the Basics with RCM 101: Healthcare billing cycles

As golf great Arnold Palmer once said, “Putting is like wisdom, partly a natural gift and partly the accumulation of experience.”

There’s certainly truth to that, but it’s good to remember that Palmer was in charge of a golf game, rather than a healthcare revenue cycle.

And as any practice administrator will tell you, revenue cycle management can be difficult and complex to understand—it takes a wealth of experience to build a winning RCM strategy.

That’s why we’re devoting multiple blog posts to getting back to the basics, a 101 course in the fundamentals of revenue cycle management strategies and tactics. Combined, this information can help you lay the foundation for a stronger overall revenue cycle—one that will not only increase profitability, but will also improve the patient experience.

First up, let’s get back to basics and talk healthcare billing cycles. Here are three fundamental ways you can put the right tools and workflows in place to improve your billing results.

1. Find the right clubs. In golf you need to build a set of clubs that works for you – the ideal combination of driver, putter and wedge irons to help you improve accuracy and heighten your chance of winning. Likewise, with your revenue cycle, you need to build an arsenal of tools and technology that cultivate a fine-tuned billing process, including:

• Your outsourcing partner, a high-touch billing company with experience who can help you manage the entire billing process
• RCM solutions that help you streamline the billing process and drive greater convenience for your patient payments.
• A strong clearinghouse partnership that will help you get claims out electronically and streamline claims management

2. Avoid hazards. In golf and in billing, staying away from sandtraps and other hazards is key to success. For your practice, that means making sure you’re putting your resources to work in the right ways and steering clear of the common mistakes that billing teams make. Three areas to review:

• Processes. If you’re not moving more of your billing processes to be handled at the front-desk, you’re creating a collections hazard. Today’s front-desk teams should be confident in talking about and taking payments, sharing patient estimates, and proactively informing patients of all of the convenient ways to pay their bills.
• Teams. Make sure you have the right person in the right job.
• Cost of operations. Make sure you understand the true cost of your operations and the age of your billing technology systems, so you can look objectively at the costs and analyze areas for improvement.

For even more insight on avoiding common healthcare revenue cycle hazards, take a look at How to Lose a Patient in 10 Ways.

3. Focus on where you want the ball to go. Keeping your eye on the ball sounds easy, but it’s just as tough on the golf course as it is in your practice. Once you’ve made a commitment to improving the billing process and offering more convenient payment options for your patients, make sure you establish benchmarks and key performance indicators that will help you mark progress. A good business intelligence solution can help you gather deep actionable insight from reports and data to help you get there.

Read our Working with Payers 101 for even more analytics insight.

While he wasn’t worried about patient payments or insurance denials, there’s no doubt Palmer was one of golfing’s best. He was also a pretty smart guy who said something else applicable to your revenue cycle: “The road to success is always under construction.”

With that in mind, jumpstart your RCM knowledge right now with our on-demand webinar: 6 Steps to Improve Your Revenue Cycle in 6 Months.