Optimize the Revenue Cycle to Increase Profit without Adding Patients

Some health care organizations believe that increasing the number of patients walking through the doors is the surest way to see an increase in revenue. While this is one way of increasing profit, there are several actions your organization can do to optimize the revenue cycle and increase revenue before the patient is seen.

Scheduling the Appointment

Under most circumstances, the initial contact an office has with the patient is over the phone while scheduling an appointment. Developing telephone scripts for office staff is essential to ensure that all necessary information is collected at this time. Make sure these scripts follow the sequence of the practice management system so information can easily be entered. Collecting all required information up front enables you to perform patient eligibility verification, receive appropriate referrals if necessary, inform patients of their financial responsibility such as deductibles, co-payments, and coinsurance, all prior to the office visit.

Hours of Operation

Another factor impacting the bottom line that should be evaluated is your hours of operation. Is your first appointment at nine in the morning and your last appointment at three in the afternoon? If so, you might be limiting yourself to a smaller patient population, and excluding those who work nine to five and are unable to schedule an appointment during those times. Consider implementing extended office hours one evening a week to accommodate those patients unable to schedule a visit during the day.

Claims Process

Although all office visits for the day are complete, the revenue cycle continues. Another element impacting revenue includes charge entry and claims submission. It’s a best practice for office charges to be entered within one day and for hospital charges to be entered within two days of receiving all necessary information, such as, operative notes and demographics. This is typically an area where lost charges can occur, and by preparing a monthly reconciliation, these lost charges can be decreased or eliminated.

When it comes to improving your revenue cycle, it’s essential to evaluate your key indicators to determine which areas are in need of additional attention and concentration. The beginning process of obtaining demographic information, eligibility verification, pre-certifications, authorizations, referrals, and entering charges can either accelerate or postpone the speed at which the organization receives its earned money. With effective internal processes, you can directly impact your revenue without increasing the number of individuals entering the practice. The Anders Health Care Services Team can help your health care organization identify opportunities and implement revenue cycle improvements. Contact an Anders advisor to learn more.