8 Tactics to Improve Revenue Cycle Management for Your Practice (2024)

• CollaborateMD Staff

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Whether you’re part of a larger hospital or run your own private practice, improving revenue cycle management means improving your bottom line. Reducing rejected claims, shortening payment lag, and otherwise smoothing your payment processes will increase your office’s efficiency and help bring more money into your practice.

With that in mind, here are eight ways to make your revenue cycle more efficient.

Improve Appointment Scheduling

The first step of maximizing revenue cycle efficiency is making sure you’re getting the right number of patients through your door. There are two sides to this equation—making it easier for patients to schedule their own appointments and sending out reminders to reduce the number of no-shows. Together, these play a big part in improving your medical practice revenue.

Upgrading your practice management software can solve both problems and improve revenue cycle management. Find a PM system that includes a robust patient portal for self-scheduling, and that includes automated reminders—especially text/SMS messages—to help patients show up on time for their appointments.

Automate Patient Eligibility Verification

Automation is an easy answer for improving efficiency in your practice, and patient eligibility is an ideal task to get off your staff’s plate and over to an AI. By ensuring patients are eligible for treatment ahead of time, you’ll reduce claims rejections and remove a common pain point from your billing process.

Adding automation has a ripple effect on office productivity. When staff members can skip the boring and repetitive work, they’re able to spend more time working on projects that actually require a human touch. Furthermore, their morale generally improves as they see their work take on more meaning.

Verify Payment Processes Up Front

This goes hand-in-hand with verifying patient eligibility. When a patient makes an appointment with your office, your staff should collect up-to-date information that includes verifying their insurance and method of payment. If the patient self-schedules through your portal, they should be able to enter this information as part of the process.

Offering patients the option to pay online is a good way for practices to encourage timely payments, as it’s both convenient and familiar to patients. In general, the simpler and more accessible you make your payment process, the better your patients will respond.

Modernize Claims Processing

Claims scrubbing is the process of ensuring accuracy, correctness, and completion before submitting claims to insurers. It’s an easy way to improve the chances of being paid promptly, and it’s another task that is well suited to automation.

Instead of the long and arduous manual undertaking that claims scrubbing used to require, modern software has made the process nearly instantaneous. There’s simply no reason your practice should ever submit a claim that hasn’t been vetted by your in-house clearinghouse.

Outsource Medical Billing

Of course, one of the easiest ways to improve your medical billing practices is simply to entrust them to an expert. It’s also how many other organizations are improving their own revenue cycle management. Partnering with a revenue manager is easy, efficient, and removes the burden of revenue from your plate completely.

Your revenue cycle manager will look for ways to improve your process efficiency to capture more charges and get you paid faster. When looking for ways to get better, bringing in an expert is never a bad idea!

Manage Claim Denials

Denied claims are inevitable, but they can be minimized through careful planning and attention to detail. For example, outsourcing your revenue cycle management to experts can result in a 99% first-pass acceptance rate. That’s obviously an outstanding benchmark to aim for no matter how you choose to manage your revenue cycle.

It’s also important to follow up on denied claims. Many denied claims get lost in the shuffle and are never resubmitted, meaning lost revenue for medical offices. Having PM software that can automatically flag denied claims for review and resubmission will help ensure your revenue cycle doesn’t experience any serious disruptions.

Track & Follow Up on Claims

Denied claims aren’t the only thing to follow up on. Have a plan for contacting patients who aren’t paying on time—it’s even worth creating a script for your staff to follow when reaching out to those who are delinquent on payments.

Present these patients with options—would they like to set up a payment plan, pay things off in full, or come up with another solution? Allowing for this sort of flexibility will help you maximize the revenue you collect from these situations.

Improve Revenue Cycle Management with KPIs

Measuring Key Performance Indicators is the only way to truly gauge the efficiency of your revenue cycle. There are many KPIs worth tracking, but start with these five:

• Total reimbursem*nt collected

• Net collections ratio
• Time claims spend in accounts receivable
• First-pass acceptance rate
• Denial rate

Having an analytics tool where you can monitor all of these statistics (and more) on a single dashboard will make it much easier to track your progress as you work on optimizing your revenue cycle and improving your bottom line.