What is Revenue Cycle Management Transparency’s Role in Keeping Healthcare Facilities Afloat?

While it’s true that patients are the lifeblood of any healthcare provider, it’s the accounts receivables that keep the proverbial chimneys burning. After all, if billings are not collected on time, your clinic or hospital may very well find itself short on cashflow. This, in turn, can have catastrophic effects on both your bottom line and your ability to service the infirm.

The Possible Problems

Of course, there many reasons why medical facilities can’t bill accounts receivables in a timely manner. The first and most common reason is that patients simply do not have the financial capacity to pay their medical bills. Such a problem can be alleviated by engaging the services of an eligibility expert, which can help your patients identify what government-sponsored programs they qualify under so that the government—and not third-party payers—will reimburse you. Read more from this blog: http://bit.ly/2yaKms3

What Is Revenue Cycle Management? Hospitals Seem to Fail to Capitalize on Its Benefits

Hospitals could bring in more revenue if they choose to focus on revenue cycle performance over costs. In fact, some hospitals are even showing a concerning flat performance in revenue cycle management.

According to best practices firm Advisory Board, various health systems and hospitals are missing out on a huge opportunity to increase revenue due to lagging revenue cycle performance. In fact, an average hospital with 350 beds has overlooked an opportunity to earn as much as $22 million in revenue capture, according to the firm’s analysis.

What seems to be the problem? According to National Partner for Consulting at Advisory Board James Green, a number of critical benchmarks have been continuously sliding or have remained stagnant since 2011. Because of this, Green believes that there is now a need for “strategic overhaul.” That also means meeting the four key challenges that face revenue cycle performance today. Read more from this blog: http://bit.ly/2wl1vOC

What is Revenue Cycle Management Going to Be if GOP Proposal Gets Passed

After a rocky start, the GOP are once again ready to try their hand at getting their version of the healthcare bill passed. Republicans have been very secretive about the entire drafting process, working on it behind closed doors and away from the prying eyes of outsiders.

While there had been little known about what could be in the draft, the obvious anticipation is that the proposal will aim to repeal and replace significant portions of the Obamacare. The main concern of everyone awaiting this new version of the proposed bill is that it will ultimately deprive as much as 23 million people of their access to a viable healthcare system.

Worrisome Budget Cuts

In the past few months, concerns have been growing not only about the fate of the Obamacare, officially known as the Affordable Care Act, but also about the future of Medicaid and social security benefits. Read more from this blog: http://bit.ly/2uEIhVT

What is Revenue Cycle Management Going to Look Like with Increased Consolidation?

Today’s news stream brims with discussions around the increased levels of consolidation in the U.S. healthcare industry. Meanwhile, many healthcare providers are now asking, “What is revenue cycle management going to look like with a rise in consolidation?”

To understand any coming changes, the recent trends in consolidation need to be examined carefully by providers and their revenue cycle management companies.

The Shift to Value Based Care

National healthcare expenditures continue to rise, currently at a level of 18%, compared to only 12.5% in 1990. The onus now rests on healthcare facilities to find a way to combat this rise. Generally, they are countering with significant consolidation of services.

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What is Revenue Cycle Management in the Age of Healthcare Consumerism?

For the longest time, the healthcare industry’s status quo has been more or less intact. Yes, technological advances have been introduced, but the way hospitals conducted business was mostly the same: patients come in, they get treated, then they get billed.

However, public policy driven changes have led to a shift in the way patients receive medical treatment. For one, there are more walk-in clinics and ambulatory care centers that offer many of the services one could find only in a hospital years past.

Moreover, more patients are opting for high deductible plans from the health exchanges, which means that more of their medical costs are being paid out of pocket. Many feel that this is a more cost-effective option, especially those who are relatively healthy and very rarely get sick.

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What is Revenue Cycle Management Going to Look Like if Obamacare is Repealed?

There have been months of speculation as the general public waited to hear about the future of Obamacare: will it be reformed, repealed or left as is? The uncertainty has health providers asking “what is revenue cycle management going to look like after these changes are implemented?”.

The Obamacare repeal bill looks to replace and change many key aspects of the legislation, including tax credits, health savings accounts and tax hikes. This bill will face appraisal and critiques, but regardless of public reception, hospitals need to be able to adapt enough to still allow an efficient revenue cycle management flow.

There are companies capable of helping improve revenue management cycles so that processes are made as straightforward as possible without compromising on consumer care.

Health Insurance Tax Credit Changes

It has been announced that there will be a new health insurance tax credit scheme introduced in 2020, which will apply to all those not offered health insurance at work and those without Medicare or Medicaid. Patients will be eligible for a block amount of credit, depending on their age, and each family will only be eligible for up to $14,000 total. Read more on this article. http://bit.ly/2mqNPfS

What is Revenue Cycle Management Going to Do For Hospitals for 2017 and Beyond?

According to research conducted by Zion Market Research, the global revenue cycle management market will enjoy an increase in its profit by the year 2020. This projection is relevant for institutions relying on this particular service because it is a clear indication of just how much stronger the need for revenue cycle management service is going to be.

Importance of Service

What is revenue cycle management (RCM) doing for institutions like hospitals? Plenty! They allow for a more streamlined and efficient process from the moment a patient checks into their system up until their insurance is taken care of and their billing transaction is finalized. With shake-ups in the Affordable Care Act practically guaranteed under this new administration, however, the need for a more adaptive system for healthcare institutions has become more crucial than ever.

While the ACA is suffering from great uncertainty, your hospital could not afford the same. Now more than ever, RCM services can help mitigate the impact of an otherwise confusing set of changes expected to hit the healthcare system soon. Read more from this blog: http://bit.ly/2mBhbry

What Is Revenue Cycle Management and How Does It Encourage Patient Loyalty?

In today’s competitive healthcare industry, patient loyalty has become very important in defining what is revenue cycle management success in your hospital. It’s no longer just about treating patients and sending them on their way. Today, you also have to focus on ensuring good patient experience so that they will readily come to your facility again when they are in need of a consultation or even emergency health care. On the other hand, revenue cycle management, which includes patient intake to billing and anything in between, must be improved to gain your patients’ trust.

Across just about any industry today, establishing loyalty among customers is key to making sure that a company would always hit its targets when it comes to both revenue and profit. After all, patient collections will go much more smoothly with a patient who is loyal to your healthcare facility.

Establishing loyalty with every single patient takes time, but there are several ways to encourage it while he or she is still being treated in your facility. Read more from this blog: http://bit.ly/2jkUlqV

What is Revenue Cycle Management Amid the Growing Numbers of ACOs?

Being in the healthcare industry is both a civic duty and a business. On one hand, hospitals and similar facilities are entrusted with caring for the population’s health; on the other hand, they need to turn a profit, in order to continue offering their services. Given the high cost of medical care, however, hospitals often succeed in providing the former but struggle with the latter.


In recent years, eligibility services have helped hospitals avoid potential bad debt. Some companies assist patients in enrolling for government programs, such as Medicare, so they can get subsidized healthcare and minimize their out-of-pocket costs—the greatest source of potential medical debt. Read more from this blog: http://bit.ly/2iqFmJZ

Supplementing Revenue Cycle Management Companies with Helpful Tools

When it comes to delivering quality healthcare, it’s not just about being able to provide the necessary equipment and service to treat the patient. Healthcare is a comprehensive, holistic experience that spans from the moment the patient arrives in the facility until they are checked out completely.


In all of this, it’s fairly easy to understand how the staff can be inundated with administrative tasks on top of their medical duties. What is revenue cycle management further contributing to this status quo is a lot more complication that can very well affect the operations of the facility as a whole. This is why alternative options exist, such as, supporting agencies that can provide assistance to the facility for this particular task.

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The Need to Ensure Patient Eligibility

One problem that weakens a hospital’s revenue cycle management is the failure to ensure patient eligibility for insurance. Because many practices don’t have the time to gather insurance information when a patient calls to set up an appointment, the risk of claims being denied is higher. In fact, thousands of claims are denied due to eligibility issues, thereby affecting the hospital’s revenue. This is why it’s important for hospitals to find a partner who can do this task for them.

Understanding the Basics of RCM

While most people see Revenue Cycle Management as simply the billing and filing the claims of patient, that is not actually the whole picture. True, the whole revenue cycle management starts as soon as the patient steps inside a hospital or clinic.

Collecting Revenue from Eligibility

Collecting revenue is essential for every active business. It is especially so for the medical profession, which works smoothly because of the use of expensive diagnostic equipment and highly educated staff that demand good salaries. It is not anticipated that indigent patients will ever pay their hospital bills, which only leaves a finance department that collects with efficiency all the monies due the hospital from all the available resources.

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.

What are RCM Best Practices for Denial Handling?

With more patients relying on the government to supplement their healthcare needs, every medical facility’s viability depends largely on effective revenue cycle management (RCM). One of the most important phases of RCM is denials resolution; a facility can lose thousands of dollars each year if they don’t appeal denials. This article will serve as a brief guide for billing officers:

Time to Rethink Revenue Cycle Management

As the dust settles on the changes brought about by healthcare reform, the need for a ‘culture shift’ regarding how hospitals approach their patients will become much clearer. At present, many hospitals focus on providing appropriate care while compensation is sorted out later. Unfortunately, this type of system presents certain challenges, which current revenue cycle management processes are ill-equipped to handle.

A recent report from the Healthcare Information and Management Systems Society (HIMSS), titled Rethinking Revenue Cycle Management, identifies four of these challenges, namely: rapid growth in consumer payments, reduced payer reimbursement rates, an ever-changing regulatory environment, and shifting consumer expectations. If hospital executives want to survive as healthcare evolves and becomes more patient-oriented, they will have to shift their focus on revenue cycle management and rethink their front-end management systems.

A proactive approach must be taken to collecting payment upfront. This helps ensure that patients understand how to get what they are eligible for and educate them on how to control their out-of-pocket costs. 

Shifting to this kind of focus will be difficult for many hospitals, as it involves the complete overhaul of many systems. There really isn’t much choice in the matter, though. Hospital sectors must start realizing that caring about compensation is essential to providing quality care for patients as the healthcare system expands and changes, lest they run the risk of losing their business.

How to Improve Hospital Revenue Cycle Management

To maintain a steady income for your health facility, you need to counter the effects that come with cash flow declines as well as changes in margins and the accumulation of bad debts. This may seem challenging, but with a good revenue cycle management plan, you will be able to achieve your goals. Here are a few solutions you can use to improve the revenue cycle management of your hospital:

Pre-Screening Patients for Medicaid Eligibility

Growing financial pressures are forcing hospitals to re-evaluate the question of what makes good revenue cycle management. Processing claims and payments isn’t enough. Hospital administrators need to be able to maximize their ability to capture revenue from all of their patients – regardless of their current financial situation.

Making Sense of RCM

Many hospitals in the entire country tend to get stumped over accounting for their operations and the bottom line. In some respects, part of making situations better requires taking stock of processes such as revenue cycle management, or RCM.

What is revenue cycle management all about? Essentially, it’s the process by which hospitals ensure that they receive appropriate payments in a timely manner. The revenue cycle starts from data collection, i.e. when the patient sets an appointment, and ends when the patient’s balance zeroes out. Throughout the process, there is a need to balance patient satisfaction and the institution’s revenue and sustainability.

Improving Revenue Cycle Management Amidst ICD-10

In October of this year, the healthcare industry is expected to head for another set of changes with the implementation of the ICD-10. Most providers, however, admitted to being insufficiently prepared for such changes, and had aired their concern on how ICD-10 can affect their revenue collection rates, claims processing, and coder productivity.

With today’s ever-changing developments aimed to provide patients a more holistic hospital experience, now is the perfect time to reflect on your current revenue cycle management and tweak and enhance the elements that need improvement.