Avoiding Mismanagement in the Revenue Cycle

Imagine having to see over twenty to thirty patients a day, or a total of over a hundred patients a week. The numbers imply profitability, and ideally, your hospital has to keep track of all of these patients and their claims. It is assumed that every hospital has a proper revenue cycle management program, however, in any busy office, systems can falter, and you may be finding yourself losing over 10% of your profit. Clearly, there is a gap somewhere in the process, and fortunately, there are professionals who can help close the gap, starting with more effective eligibility management of patients’ claims.

Keeping track of all claims from the beginning is essential, especially claims that have been denied. The system in place should be introduced to open communication between the physician and the financial staff. Losses in revenues might seem small the first few times they are overlooked, but getting the flow of revenue in constant movement, while being monitored, is important to prevent any more losses from piling up because of weak management of processing patients’ claims.

It follows, then, that everyone in your staff must be aware of the revenue cycle, and understand the role each one plays in the process. One small infraction might bring the whole system down, so training and information delivery along staff and management levels should be carried out.

Obtaining the latest technology for better revenue cycle management is just as essential. The goal is to lower the risk of revenue loss by, among other things, automating billing system and reducing data errors.


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