Are Common Revenue Cycle Management Mistakes Losing Your Hospital Money?

Consider the top 10 areas where your healthcare organization could be leaving money on the table

By Stoltenberg Consulting

According to the American Medical Group Association (AMGA), system-affiliated medical groups lose nearly $250,000 loss per physician annually. Revenue cycle labor shortages, registration missteps and documentation errors all potentially lead to increases in controllable denials. Is your healthcare facility making RCM missteps? In what ways are your staff missing out on claims reimbursement and cash flow wins?

1. No Shows – How fast are no show and canceled appointments rebooked? To minimize missed revenue, use 15-20 minutes per day rebooking missed appointments. Rebooking calls see the highest success if performed the same day.
   
   
2. Insurance Eligibility – Everyone runs insurance eligibility prior to appointment date, but do you re-run at check in? Ten more minutes spent capturing correct insurance at check in can easily save two to three hours of back office staff time to work a completely avoidable denial.
   
   
3. Copay Collection – Are expected copays included within the two initial critical steps of patient communication? When creating appointments and during reminder calls, staff can easily boost copay collection with the right copay verbiage.
   
   
4. Inconsistent Processes – Over time staff can grow complacent and perform revenue cycle steps inconsistently. To regain lost traction, use easy reference guides to coach and mentor adherence to prescribed workflows. Follow up with spot audits to identify deficiencies in critical workflows.
   
   
5. Denial Trends – What are your top 10 denials? What denial shifts have occurred since last quarter? These answers demand consistent, detailed denial reports and root cause analysis. If your coding team needs help, schedule a training webinar. If chart documentation is lacking, one-on-one provider education takes very little time. Both can dramatically decrease preventable denials.
   
   
6. Revenue Cycle Leakage – Which revenue cycle phase is your weakest point? Front-end, middle or back? Successful CFOs know which revenue cycle phase is their biggest headache. Report out lag times for charge entry, claim generation and remit posting. A bad DNFB used to mean a coding backlog, but today, revenue cycle issues are very complex and more costly.
   
   
7. Payment Plans – Cut A/R Days and increase cash with payment plans based on patient financial ability. Offer a discount to true self-pay patients if the balance is promptly paid in full or paid prior to service. Are you on par with what your peer facilities are offering?
   
   
8. Ongoing Training – New hire training? Sure, everyone does that, but what about education for existing staff? Ongoing training is critical for proper EHR use today. Include quick guides, visual examples and checklists. When a problem arises, refresher training can quickly curb end-user error and stop a problem from becoming an issue.
   
   
9. Incomplete Claims Data – Are you plagued with denials for missing authorization numbers? Push for proper workflow and stop wasting valuable time resubmitting claims. Create edits for authorization numbers based on procedure codes. Ensure your claims are compliant with payer coverage regulations.
   
   
10. Statistical Data – Share reports with patient onboarding locations and encourage competition. By location, report total copay collected, rate of missed or canceled appointments, and denials for incorrect insurance. Give performance incentives; recognize quarterly winners with achievement certificates and award a day off for annual winners.

Maximize ROI With Stoltenberg's Revenue Cycle Checkup

Ready to take action for your RCM success?

To gain a financial advantage, turn to Stoltenberg Consulting's Revenue Cycle Checkup to ensure improved processes for charge capture, claim generation, denial reduction and shorter payment cycles.

As proof of client success, less than 60 days into implementing Revenue Cycle Checkup recommendations, hospitals saw a 50% increase in cash flow with a 25% drop in Days in A/R. Stop leaving money on the table. Stay competitive amidst value-based care demands with our revenue cycle management solutions.

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