How to Plan Your Revenue Cycle Process: A Beginners Guide
The revenue cycle is an important process within healthcare organizations. It helps administrators manage patient check-in, billing, insurance verification, clinical documentation, and other processes that are essential to maintaining financial health while also providing care. If you’re just beginning your journey as a hospital administrator or hoping to take on more responsibilities in your current position, you might be wondering how you can plan the revenue cycle for your healthcare organization. The good news is it isn’t very difficult! In this blog post you will learn about the various processes that are part of the revenue cycle as well as how you can plan yours from start to finish. Keep reading to discover everything you need to know about planning your revenue cycle as an administrator!
What is the Healthcare Organization’s Revenue Cycle?
The healthcare organization’s revenue cycle refers to the collection of processes that bring in revenue. The term is generally used in relation to hospitals, but it might also apply to other types of healthcare organizations. These processes include registration and billing. The revenue cycle has three stages: Registration – This is when patients arrive at the hospital and are prepared to be treated. Registration includes checking in, consenting to treatment, and providing information about insurance coverage. Billing – This is when the hospital bills insurance companies and patients for their treatment. Collections – This is when the hospital collects payment for the services provided. When patients pay for their own treatment, the revenue cycle is slightly different. In this case, the revenue cycle includes only two stages: billing and collections.
Identifying the Stages of your Revenue Cycle
The first step in planning your revenue cycle is identifying the steps in your current process. You can do this by conducting a review of current policies and procedures. Conducting a thorough process analysis can help you identify where the areas of opportunity are within your revenue cycle. You can also take a look at other organizations’ revenue cycles to gain more insight into the various stages of your own revenue cycle process. Hiring a consultant such as WWS to review your system can also be helpful.
Step 1: Define your current process
Before you can begin to change and improve your revenue cycle process, you must first understand the exact steps involved. To start, collect data on your organization’s customers, including demographics, volume of services provided, actions taken, and payment options. Collect data on your financial situation and revenue cycles to get a better idea of where there might be opportunities for improvement. Analyze data to identify trends and patterns, such as the particular days of the week or times of the year when revenue is the highest or lowest. Next, break the revenue cycle process into stages. You might break it down into registration, billing, and collections or include other stages such as insurance verification.
Step 2: Benchmark against peers and competitors
With an understanding of the current state of your revenue cycle process, you can then compare it against your competitors and peers in the industry. By doing so, you can identify areas where your organization is performing well and those where improvements could be made. For example, if your peer hospitals are seeing an average payment of 90 days while your organization is experiencing an average payment of 120 days, you know that your process could be improved.
Step 3: Determine where you are losing money
By taking a close look at your current revenue cycle process, you can evaluate where it may be costing you money. For example, if clinical documentation is taking longer than it should be, or if billing is taking a long time to be completed due to bottlenecks in the system, you might be losing money. You can also evaluate your workflow and checklists to determine whether they are efficient or if they are causing bottlenecks and delays in your organization.
Step 4: Identify where you can save money
After determining where your revenue cycle process could be costing you money, you can now evaluate where you can save money. For example, if your documents are being sent to a transcription company instead of being transcribed in-house, you can save money by bringing transcription back in-house. You can also take a look at your software programs and their capabilities to determine whether there are ways in which they can be optimized to save you money.
Step 5: Plan for these changes
After you’ve identified potential changes to the revenue cycle process, it’s time to plan for those changes. Planning for change is essential as it allows you to take a step back from the immediate pressures and demands of your daily job and allows you to take a strategic approach to improving your revenue cycle process. Planning for change involves understanding the change, creating a timeline, and assigning the right resources to the task. Planning for change allows you to create a budget for the necessary changes and gives you the time necessary to complete the work correctly.
CONCLUSION
The revenue cycle is an important and complicated process within healthcare organizations. It helps administrators manage patient check-in, billing, insurance verification, clinical documentation, and other processes that are essential to maintaining financial health while also providing care. It’s important to understand that while the revenue cycle process is important to your organization, it is constantly changing. As an administrator, it is your job to keep up with these changes and ensure that your organization is always operating as efficiently as possible. If you’re just beginning your journey as a hospital administrator or hoping to take on more responsibilities in your current position, That said you are not alone Hiring an expert team such as WWS to your medical specialty makes sense when you’re looking for help with your Revenue Cycle Management Requirements. Our extensive list of clientele demonstrates our successful track record with different specialties. A niche service, our competencies helps you in improving your revenue right away.
