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Top 5 Tips for Improving Your Revenue Cycle Management

Top 5 Tips for Improving Your Revenue Cycle Management

With proper care and management, your hospital’s revenue cycle can be one of your business’s most essential and lucrative areas. Hospital revenue cycle management is not always easy, particularly when considering the number of stakeholders involved in the process. From insurance companies to patients to physicians and more, each party has its expectations, which may often be at odds with one another’s.

You can streamline your operations with a revenue cycle management service. This includes all the steps required to get reimbursed by insurers for claims processed by your hospital and its medical staff. Here are five tips to improve your hospital’s revenue cycle management.

#1 Hire a designated care coordinator

A designated care coordinator is a person who cares for a patient from admission to discharge. They will be responsible for ensuring that all necessary procedures are completed on time and that everyone involved with the patient understands their role in the process. To keep up to date with value-based reimbursement, a care coordinator should always stay current with new legislation and policy and measure the organization’s efficiency.

Hiring a care coordinator for your healthcare organization can help streamline your revenue cycle management. So whoever you hire must have experience in several areas, including communication, being responsible for monitoring, and project management. It is better if they have experience as an administrator or manager.

#2 Use Software Solutions

To improve your revenue cycle management, you should consider using software solutions to automate your manual processes. This will help prevent errors and ensure your data’s accuracy, enabling you to identify areas of improvement in real-time quickly.

  • Software solutions can also help streamline your billing process by offering online payments and scheduling appointments, making it easier for patients to get the care they need on time.
  • Create a waiting room that is designed for efficiency and does not waste time by having people stand in line for hours. This can be done with a simple computerized check-in system.
  • Utilize an online registration process, which allows patients the freedom of filling out the form from home and scheduling an appointment from the comfort of their own homes.

#3 Audit your denials

A great way to improve revenue cycle management is by conducting a denial audit. This process entails reviewing your denials for possible overpayments, underpayments, and other errors, to better understand how often these mistakes happen and how much you might be owed.

You can do a denial audit internally or with the help of an outside consultant. Either way, it will help you understand where any weaknesses in your system may exist, and then you can improve them so that fewer mistakes are made.

#4 Track performance

In the healthcare industry, revenue cycle management is a crucial part of the business. It’s essential to keep track of your organization’s performance to improve and stay competitive.

Find out where you are doing well and where you need improvement. With this, you can focus your resources on the right areas.

Another helpful way to improve your hospital’s revenue cycle management is by benchmarking yourself against similar hospitals.

Don’t be afraid to consult with outside sources for help, either. It can be hard to know what needs improvement if you’re not an expert in every area of hospital operations.

#5 Automate patient financial experience

One way that hospitals can improve their revenue cycle management is by automating the patient’s financial experience. This will include updating the registration process, new patient forms, and statements. In addition, automation tools for discharge processes may be beneficial in reducing errors and streamlining post-care instructions.

Also, review your current contracts with payers, so they don’t have restrictive terms like requiring a provider to use a specific billing service.


The more efficient your hospital is, the higher your revenue will be. Following these five tips can improve your revenue cycle management and help you achieve your business goals. You need to manage all aspects of your revenue cycle with a holistic approach. You can streamline operations by integrating various departments and optimizing workflow. Implement the latest technology to increase productivity. You must ensure you collect payments from uninsured patients, so they don’t go into collections. Also, ensure you train the staff in customer service and keep up-to-date on changes in healthcare laws.

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ASC Revenue Cycle Management Helps You Overcome Practice Challenges

As a medical practitioner, you realize there are many roadblocks and challenges that inhibit your strengths as a provider. ASC (ambulatory surgery center) revenue cycle management can help you overcome those challenges, identify gaps in the process, and focus on those areas that have a positive impact on your revenue cycle. An internal audit of sorts on a regular basis can assist you in identifying key performance indicators. Let’s take a look at some benefits of ASC revenue cycle management practices that can help you overcome those practice challenges.

Accuracy in scheduling: Getting accurate and complete information when scheduling your patients seems like it would be fairly easy but this is a task that often falls through the cracks. Gathering patient names, insurance, birth date and other pertinent information is standard practice, but oftentimes this information is not verified, leading to a lot of energy expended later tracking all of it down. This not only wastes time, it also can result in claims being denied or delays in payment collection. Both of these affect your bottom line, so it’s important to get it right the first time. It’s time to take advantage of online pre-admission technology that allows the patients themselves to update their medical histories on their own time, such as at home before their appointment.

Verify benefits in advance: Rather than waiting to the last minute (aka, when the patient shows up for the appointment), good ASC revenue cycle management practices dictate that you ensure patient coverage well before the procedure or appointment. This way, you can pinpoint any potential issues beforehand, get them rectified and have a seamless day-of experience. This includes verifying coverage for the actual appointment or procedure, making sure you have obtained the proper referrals, determined deductibles, etc. ASC revenue cycle management software can track insurance data, benefit information, and surgery coverage qualifications all in one place. As a result, you can cut down on collection costs, prevent last-minute cancellations, and decrease bad debt.

Outsourcing coding and billing: Handling coding and billing in house can be overwhelming and ineffective, taxing your already-stressed staff members who are expected to tack on more duties to their crowded days. When you outsource your coding and billing, you’re able to get your claims processed in a more timely manner and with increased accuracy, with one central database for information that cuts down on manual data entry. No more billing, insurance or collection delays!

Get in Touch with Medical Healthcare Solutions

Medical Healthcare Solutions offers ASC revenue cycle management services for ambulatory surgery centers (ASC) with software that allows us to benchmark key revenue cycle management performance indicators. As a result, we can better determine your strengths and weaknesses and implement the right improvements to your bottom line. Give us a call to learn more about our ASC revenue cycle management services at 800-762-9800 or fill out our convenient online form.

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National Revenue Cycle Management

Revenue Cycle Management on a National Level

Research shows 15 cents of every healthcare dollar is put towards revenue cycle inefficiencies. In other words, $400 billion of the $2.7 trillion the United States spends each year on healthcare goes towards claims processing: ie billing, payments, revenue cycle management, and bad debt.

Why? Well, a part of the reason is attributed to outdated and inefficient manual methods when it comes to payor-provider transactions. The government has made a step in the right direction by passing the Patient Protection and Affordable Care Act (ACA) in 2010. This effort makes healthcare as a whole more consumer-driven and transforms the hospital revenue cycle space. However, with patient liability for costs on the rise and their ability to pay down balances on the decline, strong revenue cycle performance is clearly necessary in order to build up the financial health of providers.

That’s where national revenue cycle management comes in. As regulations get even more confusing and payer requirements more complex, management of the revenue cycle becomes increasingly necessary in casting the largest net possible for national medical service providers, practices and clinics. You can do your part to combat declining cash flows, tightening margins, and increasing bad debt through effective revenue cycle management that ensures a steady stream of income for your business.


Little-Known Advantages to Using a Medical Billing Service


How MHS Helps

Medical Healthcare Solutions, Inc. helps you maximize your potential reimbursements through the use of  its unique, comprehensive software. This software gives you the ability to benchmark key National Revenue Cycle Management performance indicators determining the strengths and weaknesses of your practice. It also provides a hassle-free process of reporting by national payers. Effective Revenue Cycle Management improves your bottom line and frees you up to concentrate on the more important areas of your practice, such as patient care.

MHS can help you maximize reimbursements and bring them to the highest levels by evaluating and assessing revenue cycle data for medical services all across the country. It’s no secret we have been outperforming industry standards due to our innovative model for best practice, combining cost and performance ratios.  Our full-service organization can customize solutions for your practice by focussing on key performance indicators such as:

  • Month-end data
  • Contract compliance
  • Claim submission
  • Payment posting
  • Accounts receivable

Our Revenue Cycle Management services include everything from coding reviews and electronic claim submissions to follow-up on all insurances, claims, fully adjudicated payments and the registration of patient information. Keeping everything on one platform also ensures uniformity across the board in national medical billing approaches.  

Contact Medical Healthcare Solutions

Want to know more about national medical billing or our specific services that can benefit your business? Contact MHS today or fill out our convenient online form. We apply the latest medical billing technology in order to meet and exceed even your most challenging medical billing needs throughout the year. We handle it all: complete medical billing, electronic health records and practice management services, Credentialing and ASC Revenue Cycle Management services.

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ASC Revenue Cycle Management

ASC Revenue Cycle Management As part of our continuing efforts to offer you unbeatable value, access to excellence and solutions that fit your needs, Medical Healthcare Solutions also provides our clients with ASC Revenue Cycle Management services for Ambulatory Surgery Centers (ASC); services that encompass  both traditional service bureau modes as well as online connections […]

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Medical Billing Clients

A Physician’s Guide to Revenue Cycle Management

picture of young team or group of doctors

Good practices are not complete without a healthy revenue cycle. However, with the amount of patients received by hospitals and healthcare practices, a system must be established. The system will record every single detail of the patient, regardless of its relevance. In addition, the system will act as a protocol for staff that ensures no details are missed as well as the completion of necessary processes. Once this system is in place, your practice will start to make progress.

While this seems like a difficult task, the benefits heavily outweigh the extra effort. Here are some points that will lead to a stable, and lucrative, practice.

Focus on details.

This may seem like arbitrary advice, however often times it is ignored. Every error made runs the risk of affecting both records and payment collection.

Keep on target.

    Often times when patients come in for one issue, many others get discussed along the way. Be sure to note why the patient initially came in and keep this in mind throughout the visit.

Be knowledgeable about insurance.

This information is extremely important to the visit. A physician must know what type of insurance the patient has, whether or not the visit is covered, and what out-of-pocket expenses could occur from the visit. The more transparent the physician is with the patient, the easier explaining insurance policies becomes.

Collect on time.

Payments that are made on time promote a healthy revenue cycle. Since they are a direct main cash inflow, any late payments can directly impact your revenue cycle. Educating patients about their insurance policies at the time of their admittance is the best way to collect timely payments. Setting up a department solely dedicated to collections will only add to collection timeliness.

Maintain low denial rates.

    Denial rates, no matter how undesirable, will occur. This happens primarily because of improper procedure coding and performing care uncovered by the patient’s network. Unfortunately, only about 30% of patients make sure they are eligible for the procedure before they are admitted. Paying closer attention to initial coding and, again, in-depth knowledge of insurance policies are the best ways to reduce denial rates.

Ensuring Proper Reimbursements.

    Since insurance companies try to pay out as little as they can, you must have a proper system established in order to receive all the money you are owed.

Collecting Co-Payments.

    The amount of money the patient will owe (as discussed in their insurance’s co-payment terms) needs to be clarified before admittance. This ensures there will be no discrepancy between the patient and the practice and co-payments can be immediately collected.

Be sure to Pre-authorize necessary treatments.

    There are cases where procedures need to be completed even if they aren’t covered by insurance. By pre-authorizing treatments, you are reducing your denial rates and ensuring more reimbursements while helping the patient.

Of course, these points are a way to guide you to a better practice. Keep in mind that every practice has its own specific needs. Many practices struggle with a variety of problems. Having difficulties along the way is natural and bound to happen. To ensure an improvement, your practice must be consistent and dedicated to change.  As long as you are paying close attention and avoiding careless mistakes, your practice will see progress.


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