Every healthcare provider, whether a small practice or a large facility with multiple departments, always looks for ways to optimize their revenue cycle management. Now, while for any business, revenue cycle management means simply balancing profit and expenditures, when it comes to the healthcare industry, revenue cycles turn into a more complex and extensive process, one that depends not only on efficiency but also on workflow.
Each step can make or break the revenue cycle process from the initial patient inquiry to the balance amount collected after insurance reimbursement. That’s why healthcare providers continuously need to monitor and update their processes to identify and address potential pitfalls.
So how can this multifaceted entity that revolves around the patient, provider, and insurance company be truly improved? Let’s look at how a healthcare BPO can improve your radiology center and optimize its RCM.
The two major components in revenue cycle management in radiology centers
The ability of a healthcare organization to streamline its revenue cycle management processes relies on two key components:
Efficiency: this can include automating tasks such as claims processing and payment posting and ensuring that staff members are properly trained to handle these tasks.
Workflow: simply means the steps a center takes to manage the revenue cycle from start to finish, including patient registration, charge capture, and claims submission.
By optimizing efficiency and workflows, healthcare organizations can ensure that:
- All necessary tasks are completed accurately and efficiently
- Fewer errors are made
- Reimbursement and billing lead time decrease
- Reduce time and resources
- Overall, have a more cost-effective operation.
How can healthcare BPO help improve your radiology centers’ revenue cycle management?
1. Strengthening data capture from the first contact
Accurate and timely data collection improves patient care, compliance, and efficiency. Every contact with a patient should be seen as an opportunity to capture relevant information that will affect decisions later in the process.
Getting the correct information is paramount to ensuring a smooth revenue cycle flow. Here are some of the reasons why:
- Reduces errors in coding and billing procedures. Accurate data from the first contact eliminates delays and costly mistakes in coding, billing, and payments.
- Eliminates time-consuming activities such as chasing records or trying to locate missing paperwork.
- It helps prevent misdiagnosis and wrong treatments by providing doctors with up-to-date and accurate information about the patient.
- Allows for more effective communication between healthcare providers and their patients.
- Facilitates better decision-making by providing timely and relevant data to support informed decisions regarding treatment.
- Enables better population health management by providing insights into patient populations and trends.
2. Improving medical transcription
A healthcare BPO can provide skilled and certified staff who can accurately and quickly transcribe patient records. In addition, they can also employ advanced technologies such as speech recognition software, Natural Language Processing (NLP), and other digital transcription solutions to reduce transcription errors and turnaround time.
This improved accuracy helps the healthcare facility manage its revenue cycle processes better. Furthermore, the healthcare BPO can also provide specialized training for the transcriptionists on coding and documentation guidelines so that their output adheres to all the necessary regulations, such as HIPAA, which in turn reduces compliance issues and denials due to inaccurate documentation.
3. Making extensive follow-ups with the patients
When it comes to revenue cycle management, patient follow-up is essential for optimizing the process and ensuring that claims are paid on time. A healthcare BPO can help make patient follow-ups more efficient and effective, helping your center:
- Reduce no-shows,
- Reducing any confusion or delays that may occur with billing or coding,
- Preventing or reducing data collection issues,
- Giving place for better communication between patients and the center,
- Improving patient satisfaction and loyalty.
4. Optimizing medical coding and billing process
Medical coding and billing is a complex and time-consuming process that requires careful attention to detail and compliance with regulatory guidelines. To optimize your medical coding and billing process, a Healthcare BPO will:
- Use the most up-to-date coding systems and guidelines to ensure accurate coding and reduce claim denials.
- Train your coding and billing staff to be up-to-date on coding guidelines and regulatory changes.
- Regularly review and audit your coding and billing processes to identify areas for improvement and reduce errors and omissions.
5. Monitoring processes and key metrics
Having accurate and real-time data available for quick decision-making can help your radiology center identify areas of improvement while also allowing for more effective strategies to be put into place.
A healthcare BPO can provide detailed reports on the efficiency of revenue cycle management processes and key metrics such as the number of appointments scheduled, effective appointments, average handling time, and more.
Access to this information helps managers identify issues quickly and take action to ensure their revenue cycle process runs smoothly and efficiently. In addition, these reports can be used to compare performance over time to make informed decisions on how to improve their systems.
Key takeaways
Delegating all administrative tasks related to billing, coding, and non-provider duties to a third party frees up your center’s in-house team to focus on patient care instead of worrying about payment processes.
Now, before making the decision, it's crucial to thoroughly evaluate any potential BPOs before contracting their services, mainly because information as sensitive as this demands significant expertise. It's important to confirm that the team you're considering is certified and has a track record of working with large-scale facilities.
At CCD Health, we focus on providing our clients with customized services to help them improve their processes at each step of the patient journey! Contact us to discover more about our wide range of healthcare and radiology center solutions, or BOOK A DEMO.