Revenue Cycle Management-How Well is Your Practice?

Revenue cycle management and operations are dynamic with many different components impacted by variables within practice operations. Given the diminishing margins in healthcare, proper attendance to RC processes is essential. And, with the slow crawl toward value based reimbursements and the nuances and technicalities of bundled payments, it is more crucial than ever to ensure a sound functioning RC. Whether the practice is in a heavily “managed” payer environment, remains mainly fee-for-service, or is an elective,--i.e., cash only--business, the revenue cycle system is crucial. Indeed, revenue is the lifeblood of any healthcare entity. Stunningly, some institutions continue to under-invest or place on the "back burner" the significance of revenue cycle management and its accompanying components. Healthcare margins are tighter than many service-oriented businesses and, probably, hampered by more extensive regulation than for typical companies. With that in mind, accurate billing and revenue management, from A to Z, is more vital for a physician enterprise than for your local convenience store. The process begins at check-in with proper registration and patient intake. It follows the patient in his visit and continues long after the patient has checked out and scheduled his next visit.

Physicians in employed models struggle with these variables as much as physicians in private practice. Nothing is ever as simple as it seems. For instance, the front desk and the check-in process impact the revenue cycle when staff collect (or don’t collect) copays and deductibles. In reviewing the operations of a medical practice in an attempt to identify the “ills,” sometimes the answer, while complicated, is right under your nose yet remains illusory.

Coker’s revenue cycle management work entails all pieces in the process in medical practice including, but not limited to, proper utilization and deployment of RC information technology-related systems, review of patient check-in procedures, validating and verifying accurate payments are received and posted, and examining fee schedules for anomalies. At client behest, we’ve studied components or complete systems, depending on the need.If you are curious about how your revenue cycle compares with your peers or have concerns about cash flow, contractual allowances, etc., Coker can provide an analysis to determine the cause(s) of your RC conundrum while offering suggestions to remedy those issues and demonstrating the quantifiable results of deploying suggested changes.

For more information regarding revenue cycle management, request a recording of the January 2016 edition of our free monthly webinar series, Podcast, led by Jeff Gorke, Senior Vice President. If you’d like to discuss your particular situation, please call 678.832.2021 to speak with Jeff Gorke.