Revenue cycle management is not a new term at all in the healthcare industry. In fact, a majority of healthcare service providers have chosen to outsource this or hire an external team to handle RCM because, honestly, it takes extreme effort, skills, and resources to get it right. Revenue cycle management directly affects the revenues generated by the business, and that’s why this isn’t a choice anymore.
True to the saying, ‘change is the only constant’, technology and strategies keep changing in all industries, including healthcare. What if we told you that it isn’t enough just to hire an RCM team in today’s scenario? You must be working on getting expert revenue cycle analytics services.
What are revenue cycle analytics services, and why do you need them?
Revenue cycle management is the process of managing all processes that contribute to a healthcare brand’s revenue. This means ensuring the bills are sent right, the codes are precise, there are low denials, and the documentation and follow-up processes are in place.
Let’s say your team does all this as best as they can, but there isn’t any significant change in the rate of denials or the speed with which claims are sent through. What if growth and revenues are stagnant and not moving forward like you wanted them to? Here is where the work of revenue cycle analytics services comes in.
A revenue cycle management team generates large amounts of data as they work. These are data that talk about what exactly is happening in the process, what is going right or wrong, the changes made, the inefficiencies of the team, and the skill/resource gap.
A revenue cycle analytics service team dedicatedly works on analyzing these data. They come with specialized analytical and data mining skills and are usually backed by the top technology of today – Artificial Intelligence and its subsects.
They start by talking to the client to understand what isn’t working for them in the current RCM operations and their expectations. The client could say that they aren’t satisfied with the current rate of denials or the number of write-offs they are forced to do every month.
The client may want to know what to do to achieve optimal revenues without spending anything more on resources. Or the client may want to match industry standards for the rate of denials or A/R time. Some clients may want to increase their average daily cash flow.
Once the target for the process is identified and locked, these experts work on data mining. They run tens of hundreds of tests, experiments, and analytics and generate reports that tell them a clear story on what is going wrong and what are the proactive steps to be taken.
These experts then develop clear short and long-term action plans for the brand to optimize revenues and solve revenue-based issues they may have had.
Is revenue cycle analytics service a one-time process?
No, it isn’t. The smallest of changes in your RCM operations, like the quitting of a key resource, hiring new individuals, increase in patient footfalls, change in payer terms and conditions, or implementation of a new government rule, can all instantly affect the revenue and bring down a dip.
So, it is recommended that you take the help of a revenue cycle analytics service expert at least 2-3 times a year or whenever you notice considerable changes to your revenue generation to make sure you identify problems early and nip them in the bud.
All top healthcare providers have already started working on tapping RCM analytics, and the faster you jump guns, the more stable your business will remain.
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