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  • Writer's pictureVelia Calderon

How can a good revenue cycle management approach help you avoid burnout?

Streamlining the revenue cycle can help alleviate a lot of the tension that leads to burnout.

Many healthcare providers were already nearing burnout due to the stress of their professions when COVID-19 struck. With so many demands on providers and their staff – changing laws, regulations, and standards; healthcare reform and changing payment policies; too many administrative tasks; balancing increased patient expectations as healthcare consumers with limited time for patient interactions – providers and their staff were already experiencing record levels of burnout.

During the pandemic, these tensions became even further. By keeping their office doors open, providers risked becoming infected, but their patient traffic and revenue quickly decreased. As a result, some clinicians have taken wage cutbacks, practices have laid off personnel, and many have hastened to adopt or expand telehealth services in order to keep delivering services. The Medical Group Management Association revealed that from the start of COVID-19, practices have seen a 55 percent drop in revenue and a 60 percent drop in patient traffic. Combined with an increase in expenses, the pandemic had a negative financial impact on 97 percent of practices.

The federal government moved in to provide some stop-gap assistance in an effort to alleviate some of the financial strains. The provider relief fund, which provided grants to healthcare providers to cover lost revenue and unreimbursed pandemic-related costs, the CARES Act's Paycheck Protection Program and other loans, Medicare's Accelerated and Advance Payment Programs to alleviate cash flow disruptions, and additional funds made available for certain providers under the American Rescue Plan were among them.

Revenue cycle optimization

Despite this assistance, COVID-19's financial impact on healthcare providers and practice employees remains significant. Practices must take a critical look at their internal operations and make changes that place them on sound financial footing to secure a healthy future and assist reduce the burnout that physicians and staff face. Optimizing the revenue cycle is one of the most important aspects of this.

Every year, billions of dollars are squandered on ineffective revenue cycle management (RCM). According to the 2020 CAQH Index, healthcare providers in the United States could have saved $16.3 billion in 2020 by improving revenue cycle procedures — money that might have been used to avoid furloughs, pay cuts, or practice closures.

So, how can you make sure your practice is making the most money possible? To begin, figure out where you stand in terms of basic revenue cycle key performance indicators (KPIs), such as days in accounts receivable (A/R), clean claim rates, collections per visit, and other data. Then, to see how these KPIs are moving and what changes should be made to improve performance, an analysis should be undertaken.

From the front office through the appointment itself, to back-office billing and collections, you should analyze all procedures that touch the revenue cycle.

When it comes to front-office processes, employees should gather up-to-date patient data when appointments are made so that they may check for eligibility and benefits before the patient arrives. It's also critical to stay on top of the various, and frequently changing, laws and standards for each payer, so that the information gathered by the front office aids in the creation of clean claims. Patients should be asked to supply current demographics and insurance information when scheduling appointments using an online portal.

Before the appointment, the front desk should make all financial policies explicit, collecting co-pays and outstanding balances. Payment plans can help improve revenue and reduce write-offs over time for patients who may have greater loads, have lost their employment, or are experiencing financial challenges.

Clinicians should document all interactions and gather details about the care provided once patients arrive for their consultation. As new services, such as telehealth and remote patient monitoring, become available, physicians must learn how to code for them so that they are reimbursed for all services rendered. Clinical documentation combined with data capture at the time of appointment booking will result in cleaner claims and a lower risk of rejections or denials, all of which are critical considerations in getting the practice reimbursed sooner.

It's critical that payments are reconciled on a daily basis in the back office. This basic procedure allows the office personnel to detect and resolve any billing or coding issues before they become a bigger issue, such as delaying or denying reimbursement. Furthermore, daily payment posting streamlines billing procedures, resulting in improved cash flow for the firm.

In today's dynamic healthcare environment, optimizing the revenue cycle can help eliminate much of the stress that causes to burnout. Working with an RCM vendor to improve financial performance or patient reviews surrounding billing processes, when there are a lack of staffing resources or training, or by operating as an extension of a practice's existing personnel, can be beneficial. Overall, having strong RCM systems in place allows doctors to focus less on their practice's financial health and more on caring for and communicating with patients.

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