A Plug for Stopping Revenue Cycle Leaks

It’s called a revenue CYCLE for a reason, as the process isn’t done until the circle is complete. Unfortunately, in this instance, there are numerous points along the way that can spin that process off course.

That’s why we’re hearing a lot of talk these days about “revenue cycle leakage,” a concern that always has been with us but has been exacerbated by today’s reimbursement constraints and constructs. What can healthcare organizations do to plug the leaks? Experts continue to weigh in with recommendations on how to do a better job at reducing denials, eliminating underpayments and securing co-pays, among other issues.

Noting that continuous claims denial by payers is both a “hidden expense” and “a syphon slowing draining profits” for [a] medical practice, an article on carecloud.com offered a number of tips, including:

  • Assuring patient insurance eligibility prior to a visit, gathering related information from each person and advising them as to potential costs.
  • Taking the time to take a second look to assure the accuracy of claims submitted.
  • Semi-annual review of payer contracts and tracking of renewal dates to facilitate renegotiation of terms.
  • Effective engagement of patients at encounter to collect copays.

There’s more, but we don’t want to steal all their thunder. So take a look.

For our part, we continue to urge high-quality training to create high-quality revenue cycle staff, extending to and including those charged with handling sensitive patient financial communications. Knowing what to say and when to say it can ebb the flow of lost dollars.

As noted on healthcarefinancenews.com: “Each stage of the revenue cycle . . . represents a potential point of leakage” and, while “doc thinks they have control of this . . . there can be a 20-percent difference in what they’re taking home because they’re bleeding in so many places.”

Think about what this could mean to a hospital or health system. And look out for our next blog, which will address that very same subject.