Revenue Cycle Management: The Proactive Approach

Bad debts are one of the major reasons why healthcare facilities close. Although seemingly minimal when individually taken into account, when piled up, they can amount to significant revenue loss for a practice. In fact, in 2011 alone, the American Hospital Association estimated that healthcare facilities have lost $41.1 to uncompensated care, which also accounts for 5.9% of their total expenses. Some of this could have been preventable had these facilities started optimizing their revenue cycle management processes.

Just recently, it was found that patients today are becoming more responsible for higher percentages in their health plans, which means more billion dollars could be at risk. Fortunately, more and more cost-savvy hospital managers are realizing that the old, plain way—serve then collect—would no longer work. They are now investing in more advanced tools to make their billing system more efficient.

Taking a more proactive approach, hospitals now make it a point to screen patients thoroughly for their ability to pay. By studying the information provided, hospitals are able to detect flaws in the claim. Afterwards, they call patients for corrections and re-schedule appointments to give the latter enough time to review their coverage. They even eligibility experts to work out the filing with them as needed.

The new practice entails more face-to-face interaction with patients. Experts advise hospitals to avoid using an overly-aggressive debt collection approach as this puts them at risk of lawsuits, especially when there are allegations of delayed treatment and denied access to the patient.