Healthcare RCM: Everyone’s Responsibility

August 7, 2018

Healthcare RCM: Everyone’s Responsibility

Emerging technologies now drive the transition and evolution of revenue cycle management. This is brought about by the pursuit hospitals and healthcare providers must focus on to not only improve financial system management, but to also identify hidden streams of revenue. Healthcare organizations are looking to implement newer technologies that will streamline processes, speed up insurance authorization, deliver new streams of income and minimize the time it takes to receive payment.


Improving Patient Workflow Automation

The importance of helping hospitals improve their patient workflows through automation and to accurately drop the bills on time is something healthcare technologist know all too well. Every point of patient contact, patient data collection, diagnosis and treatment, eligibility and verification are critical to the bottom line.

Although every healthcare facility may have a unique culture, whether full service or particular specialties, one thing that ties all healthcare systems together is the patients. The challenge for most facilities is the time it takes to capture patient clinical workflows and processes detailed enough to build a comprehensive and robust system. Unfortunately, developing a well-documented workflow takes multiple reiterations and can require hours of work.

Capturing accurate and efficient patient registration, admissions and eligibility, streamlining ER processes, collaborative and seamless transfers to/from healthcare facilities, enhancing efficiency and patient safety through the reduction of medication errors, to minimizing drug dosage and dispensing issues, and ultimately automating medical records management with secure accessibility –all  have major impacts on healthcare revenue management systems. One big challenge many facilities face is the lack of qualified skilled resources.


Coordination & Collaboration of Healthcare System

With increasing improvements throughout the years, many hospitals continually face the challenge of hiring and keeping qualified skilled resources through important projects. Yet, the even greater challenge comes after a productive project leadership team has been established, along with a clear vision and objectives.

Coordinating and communicating with all the respective stakeholders and areas of a hospital system takes preparation and consistency through planning. As we experience the changes in the revenue cycle system process, it no longer only impacts the traditional revenue cycle model. It impacts the entire patient workflow process, all invested departments, and the new advanced technology teams continuously working together to improve the revenue cycle management system.

Investing time to improve and change the quality of our healthcare resources is a must. One important example is frontline healthcare workers. It is critical that frontline healthcare workers understand the importance of improving the quality of patient care through gathering accurate patient information during the first encounter. Many times unskilled admission, registration and eligibility resources are hired to save money. While in the end, hours of work are spent correcting inaccurate patient information during charge capture, claims, coding, or remittance, which ultimately delays the bill drop.

Just like HIT security has becoming everyone’s business and responsibility, revenue cycle management has also become everyone’s responsibility. Whether you’re a clinician or administrator, working in admissions, registration and eligibility, operations, ambulatory, ER or IT, working together to improve the process and obtain accurate patient information is your responsibility.


Complexity of Revenue Cycle Management System

One thing is clear, the last 10-20 years have brought extensive changes in provider productivity and hospital internal revenue drivers. Regulatory changes, ICD-10 and continued mergers of revenue cycle systems have not only become the norm, but appear to be increasing every year. Hospital systems continue to invest time and money in order to gain knowledge and understanding of how new technologies can be implemented to increase their bottom line. Today, healthcare systems are looking for vendors who can provide end-to-end revenue cycle management that can solve the growing financial challenges they face each year.

There are several benefit to improving revenue cycle management such as streamlining patient workflow automation, improving productivity of departments and resources, and creating positive impacts on patient satisfaction.

By improving not only the quality of the patients experience, but educating and investing in the resources, hospital systems can successfully improve revenue cycle management. This allows for continued collaborations towards successfully finding new streams of revenue and increase the bottom line.


Nina De Los Santos, PMP

VP Operation Delivery at Excite Health Partners