Four Revenue Cycle Management Tips for Small Healthcare Organizations

Community and small hospitals, along with physician practices, struggle with multitasking business office and revenue cycle management processes. To help these short-staffed organizations without additional resource strain, utilize these four tips for healthcare revenue cycle management success.

  1. Assess payer contracts in detail annually- Typical payer contracts outline the discounted rates for your facility's most commonly performed procedures. If your patient population has become more complex, but you fail to align these changes with payer contracts, you could be missing out on reimbursement. Run usage reports to identify volumes for the top 20 performed procedures to give your facility an advantage in payer contract discussions.

  2. Conduct a deep data dive of your top 10 denial codes- Follow up by identifying the payer for each. Define the root causes for each denial and correct faulty processes or overlooked steps. If poor coding is the root cause, educating providers will take very little time. Just make sure all applicable staff learn the proper coding with consistency, so the issue doesn't repeat. If procedure authorization is the concern, business office staff may need additional front-end training.

  3. Promote patient portal use- Today, patients expect health portal access, including mobile, to see care cost estimates, directly submit payments, use secure messaging, and access patient health data and care treatment documentation, no matter the size of the healthcare organization. By promoting portal use, providers can gain easy Merit-based Incentive Payment System (MIPS) Promoting Interoperability (PI) points under the Quality Payment Program, while saving staff significant time and reducing days in A/R. This is especially important to streamline the patient communication and payment collection processes that coordinate with expanded telehealth usage.

  4. Offer patient payment plans- To also cut days in A/R and make patient collections easier, offer payment plans based on patients' financial capabilities. Many facilities now offer total self-pay patients a discount if balances are promptly paid in full or paid prior to receipt of care. This works well for some services, like OB delivery, tonsillectomies and elective plastic surgery. For patients struggling to meet financial obligations, offer payment plans with no interest. This saves follow-up time for the business office staff and strengthens the patient-provider relationship.

Alleviate pressure on your team. Smooth claims submission while cutting staff time with these four tips for revenue cycle management for small healthcare organizations.