For a physician group practice to be successful in today’s healthcare environment, organizations must dedicate resources toward creating a cohesive, streamlined revenue cycle and giving patients the best possible financial experience. As high-deductible healthcare plans and out-of-pocket costs continue to rise, patients are becoming more involved in the financial aspect of their healthcare and want to know more about the cost associated with the care they’re being provided. Many times, it’s more than likely that the patient will not return to the practice or leave a negative review online if he or she is disappointed or frustrated by the financial experience, even if the patient receives a great clinical experience.
If your medical practice is looking to revamp its revenue cycle or enhance its patient engagement efforts, here are three different ways to build out an effective RCM strategy and ultimately improve the patient financial experience.
1. Eliminate discontinuity between front office and back office workflows
When it comes to RCM, there has always been an age-old disconnect between the front office and back office. Many have come to think that the front office simply handles patient interactions, while the back office is solely responsible for processing claims and issuing billing statements. In reality, the revenue cycle process starts as soon as the patient schedules an appointment and continues on until reimbursement is received. It’s imperative to get rid of this “front-end” vs. “back-end” mindset and ensure that these RCM workflows smoothly transition from scheduling and registration to later documentation and patient collection phases.
Utilizing more technology and electronic payment options can significantly improve this disconnect. Taking advantage of resources such as online scheduling, online registration or text message reminders for appointments can help collect valuable data from the first patient interaction, as well as help reduce patient no-shows. Patient estimator technologies also enables price transparency at the time of scheduling to help patients make more informed financial decisions, and the ability to create prior authorizations, easing the administrative burden for patients and providers. A recent analysis from R1 found that patient collections increased from about 40 to 60 percent when potential out-of-pocket costs were clearly articulated prior to service. By incorporating technology into scheduling and registration, the front office staff spends less time on the phone confirming/working through appointments and pricing, which further eliminates the chance of data capture error, and gives the staff more time to focus on the patient experience and ensuring they receive great care.
During the post-visit interaction, it’s also important to give patients easy ways to understand and make payments. Whether it be through well-designed, itemized patient statements or easy-to-navigate online billing portals where the patient can make electronic payments, even through their cell phones, it’s critical to offer user-friendly payment options and also ensure that information collected at the registration phase is transferred seamlessly through each revenue cycle touch point all the way to the end of the financial experience. This increases overall satisfaction and makes sure your practice gets paid for services sooner.
2. Standardize RCM processes at all group practice locations
Regardless of which group practice location a patient is visiting, the patient’s experience should be fully integrated and unified at each revenue cycle touch point—verifying insurance, checking in to receive care, reconciling copays and deductibles, etc. RCM processes need to be standardized at all group practice locations, as well as at the health system level, so patients feel like they are receiving consistency wherever they go to for care. A great option worth exploring is finding a partner who has the scale and resources to manage your revenue cycle consistently from end to end to improve RCM performance at all group practice locations. Vendors who can offer solutions that seamlessly integrate into your various locations and create the technology and operational infrastructure that produces practice-wide visibility and control of financial performance will offer your organization a substantial competitive advantage.
Before reaching out to a partner to receive expertise in this space, group practices should evaluate current processes and procedures and decide what their plan should be moving forward when it comes to internal RCM workflows and creating the optimal patient financial experience. Different locations often address similar issues/cases in ways that are inconsistent, even when standard policies and systems have been put in place. Make sure to take inventory of these variances and determine what best practices you should be executing moving forward. Once your practice agrees on what you’d like to accomplish in the future, you can start to make crucial decisions around what RCM technology and business expertise you need to procure in order to achieve your practice’s goals.
3. Implement an approach that combines the right technology and business expertise
Revenue cycle technology, when implemented correctly and with the practice’s goals in mind, can create numerous efficiencies and solve challenges associated with each phase of the financial experience. However, deploying stand-alone technology to solve a certain issue or problem won’t always help your practice see any significant change in its revenue cycle.
Again, finding a partner with the right business expertise who understands how technology can be applied to your revenue cycle workflows in a meaningful way is the key to achieving long-term results. Since most practices are strapped for time and resources, many are leaning toward outsourcing their RCM to partners who are dedicated to managing the complexities of the revenue cycle and staying on top of new reimbursement trends. Others are working with partners to identify ways technology can make receiving payments easier, as well as more efficient and streamlined so the full RCM process doesn’t take as long.
A New Patient-Centered Mindset
A comprehensive approach that leverages both technology and revenue cycle expertise is the winning combination for any group practice. However, in order to achieve lasting results group practices must be open and willing to reevaluate current internal processes and develop a new patient-centered mindset.
By working with partners who know how to leverage both technology and revenue cycle expertise, group practices can simplify the financial experience for patients and ensure their organizations receive all revenue to which they’re owed. Creating one complete RCM workflow and deploying it consistently across various locations can help group practices meet financial objectives, generate increased cash flow and achieve overall patient satisfaction.