How to Optimize Your Revenue Cycle 101

Bankruptcies in the healthcare industry are trending up by more than 25% this year, and many of the organizations that faced financial challenges throughout the pandemic are finding that these challenges have not gone away. With an ongoing staffing crisis and this new data painting a grim picture of 2023, operators are being forced to make difficult decisions to stay afloat in the new year and beyond. Collecting revenue on time will be critical to the financial health of any healthcare facility moving forward. However, finding the right expertise to deal with the variety of managed care plans and their requirements for payment is often challenging. The key to overcoming these challenges will be to leverage a technology partner that can use data to pinpoint problem areas and provide recommendations for eliminating threats to an organization’s bottom line.

At the PointClickCare SUMMIT this week, we examined the ways PointClickCare customers have been able to optimize their revenue cycle performance despite these challenges, to gain a more predictable cash flow and collect revenue faster. This comprehensive panel discussion provided actionable insights covering the following areas:

Organizational design

The first step to improving accounts receivable (A/R), cash flow, and collections lies in a comprehensive review of the roles of the key staff responsible, as well as the systems they use. This initial review should aim to identify any gaps or areas in need of improvement by examining where the focus is, what the current processes are, and which tools are currently in place.

Staffing your revenue cycle operation

Last year, we commissioned an independent market research study to dive deeper into the range of revenue cycle challenges currently facing skilled nursing facilities (SNFs) in particular. The majority of SNF leaders indicated that an overall shortage of on-staff revenue cycle know-how and ballooning managed care complexity were causing them to look outside their own organizations for help.
By leveraging a dedicated team with experience in collecting from difficult payers and reimbursement programs, organizations can appropriately resolve outstanding A/R and accelerate cash flow while freeing up their staff to do what they do best – provide quality care to residents.

Leveraging technology to drive efficiencies

Once leaders have conducted a thorough review of their current processes and staffed their revenue cycle operation, the next step will be to implement claims management technology to streamline this complicated system and increase efficiency.
Optimizing the performance of a revenue cycle operation is the fastest way to boost cashflow and ensure that an organization is paid for all the services it provides. The appropriate tech will facilitate the information essential for evaluating claims with a centralized record system, resulting in:

• Improved operational efficiency
• Reduced claims management costs
• Automated insurance workflows through digital claims

The PointClickCare Revenue Cycle Management solution (RCMS) was designed to help customers improve outcomes, profitability, and eliminate risk through a contingency-based model. Its main goal is to provide customers with more predictable cash flow and lower cost to collect. By ensuring that organizations are paid accurately and in a timely manner for the services they provide, their bottom line improves.

Looking ahead

Healthcare reimbursement models are changing at record rates. To keep pace and prepare for future evolutions, healthcare providers must reduce inefficiencies in revenue cycle management, which are often mired by manual, labor-intensive processes with many opportunities for error. Optimizing a revenue cycle doesn’t have to be challenging – with the right team, tech, and processes in place, organizations can gain a more predictable cash flow and collect more revenue, faster.