We all make mistakes, even as experienced veterans in revenue cycle management. Sometimes, though, our biggest mistakes are the ones right under our nose—the ones we simply don’t recognize as mistakes because we’ve been using the same process for so long.
A lot has changed in revenue cycle. With the implementation of ICD-10, the advent of accountable care, the increasing volume of patient self pay, and the evolving payment habits of those patients, we need to constantly improve our revenue cycle processes to accommodate change in our industry. Is your revenue cycle in top-notch condition today? We speak with many industry leaders, and wanted to share what we’ve noticed: 3 major, progress-halting revenue cycle mistakes you may be making right now and how to fix them.
1. You’re relying on current staffing levels to handle the increased volume of A/R activity.
We know how challenging it is to find the right people with the right skills to keep your revenue cycle humming. There always seems to be a shortage in the marketplace, not to mention budget restraints. Because of this, most healthcare organizations are trying to “make-do” with existing staff. It’s a classic case of continually trying to do more with less. We’re all guilty of this, but in truth, we’re only hurting ourselves in the end.
With an increased volume of patients and billing providers, you’re sure to find an increased volume of accounts in your system.
If you don’t adjust any of your current efforts or processes or change your staffing models to meet the increase in A/R, you’ll quickly be facing bottlenecks and backlogs.
Focusing your staff on working the early part of A/R (whether it’s patient payments or insurance claims)— is smart. But it’s common for the volume to be so high your staff can’t touch it all in a timely manner, and, even though no one likes to admit it, sometimes accounts are “forgotten” or placed on the back burner. There are two mistakes worth highlighting here: allowing inventory to age, and not understanding or having the technology to prioritize aged vs new balances.
Focus your current staff on the early part of the A/R process. Claims that are filed in a timely manner—and filed correctly—are paid first. Likewise, patients paying out of pocket are most likely to pay in the first 30 days; after each subsequent 30 days, the likelihood of receiving payment drops exponentially. By concentrating on these early dollars, you’ll either receive payment or you’ll get some kind of denial or appeal that can be worked that allows you to maximize reimbursement. Generally, the most recent balances are also the most collectible. Don’t allow your staff to shift focus to more aged balances unless all early balances are being collected with proper rhythm and rigor.
Does that means you should ignore aged balances? Of course not, if your goal is to maximize payments and reimbursement. This is where an outsourcing firm can be very valuable. You’ll then have a hybrid strategy of outsourcing “back burner” accounts while your staff works on the early accounts.
2. You’re expecting self pay results when you’ve only sent statements.
We see this happen too often: a healthcare organization sends their patient a billing statement expecting them to take action and make the payment. Unfortunately, even the most patient-friendly billing statements may not be enough to get your patients to pull out their checkbooks. And while accepting payment via inbound calls is standard practice, it simply isn’t enough to maximize your return.
This is your cue to build an outbound calling strategy. We’ve found that most people respond in the 60-90 day period when we call, driving that “extra” revenue. Not only does this drive more patient payments, but it can also improve the overall patient experience.
Only a small portion of patients pay from their statement only. When you actively reach out to call them, your total payments will naturally grow. In general, patients just needs a little extra information, an explanation, or sometimes just a nudge to make the decision to pay. We've worked with a provider to achieve this—read about it here!
3. Your patients don’t have enough payment options.
We say this here at MediRevv all the time: patients come first.
Today, writing a check or picking up the phone has nearly become an inconvenience in light of the growth in technology and mobile phone usage. Unfortunately, many large healthcare facilities have yet to leverage new technology and trends, remaining “stuck” with aged, traditional, and outdated strategies.
Make the process as simple for the patient as possible. You can start with your patient portal—do you have one? Is it simple for them to use? Intuitive?
You may also consider utilizing a payment IVR to give the patient more options to pay. (The patient could “hit 1” to make an automated payment, for example, among many other things IVR is capable of handling).
We’ve found that IVR can serve a huge role in helping drive more patient payments by offering more options. One our favorite success stories is with a client whose payment IVR went live on March 1st of this year, allowing patients to call into our inbound lines and make a payment over the phone 24/7 without needing to speak with a representative. In the first 30 days, 1227 patients took advantage of this new functionality resulting in $133,000 in payments, approximately 15% of overall collections that month.
Prior to implementing the payment IVR, representatives received 1484 inbound calls averaging 6 minutes per call, so the IVR system saved 123 hours of inbound calling effort. Imagine how those extra hours could be used.
It just goes to show that giving the patient convenient options to pay — patient portal and IVR, to name a few — helps not only improve the patient experience and satisfaction, but it also helps your healthcare organization save time, effort, and money. All the payment and work was easily put on the patient—alleviating some of the staffing concerns referred to earlier.
The Bottom Line
If you identify with any of these mistakes, you’re not alone. Many organizations are beginning to understand the impact staff shortages, misdirected A/R follow up efforts, and lack of technology on the patient as well as on their revenue, and are making positive changes with excellent results. If you’re looking for more ways to improve your RCM and/or self pay revenue, you may be interested in our ebook, A Winning Self Pay Strategy. Get your free copy today by clicking below!