Improve Your Revenue Cycle: Work Smarter, Not Harder
In revenue cycle there are many moving parts and lots to do to ensure the correct information is obtained from the patient, physician, and payer to ensure appropriate reimbursement for services provided. There are numerous regulatory requirements and governmental laws hospitals must comply with to protect revenue. The tendency is to work harder to become better but working smarter takes less effort and can significantly reduce the cost of doing business. Here are some ways to work smarter, not harder.
Invest in Technology
Technology should be used to automate any manual processes. Removing human intervention eliminates the risk of human errors as well as the costs that go along with fixing the errors. Implementing technology allows for streamlined processes and increased workflow efficiencies. Equipping employees with the technological tools they need to be successful creates happier and more productive employees. Best practice hospitals work smarter by investing in technology.
Working smarter means continuously looking at ways to improve processes. Continuous process improvement aims to eliminate waste and redundancies in any workflow. Through the LEAN process, hospitals have become better at questioning why things are done a certain way. This constant questioning enables hospitals to identify when process improvement is needed and successfully manage the change.
Working by exception is one way to eliminate waste in a process. For example, when an insurance follow-up team is working to determine if payers have paid the hospital correctly or not, creating a report with only those insurance accounts with payment variances, allows the staff to work by exception. A focused work effort has the staff only touching accounts that need their attention which creates an efficient workflow, increases productivity, and most likely will have a positive impact on revenue recovery. Work smarter, embrace LEAN and don’t waste time and energy on work that does not add value to the organization.
Incorporate Quality Assurance/Training
High performing hospitals work smarter by incorporating a Quality Assurance and Training (QAT) component into their revenue cycle. These hospitals understand the direct impact that QAT has on the operational success of the revenue cycle functions. Quality assurance activities, such as staff observations, daily work reviews, and auditing, identify opportunities for additional education and training. QAT efforts also provide a level of accountability to ensure that any deficiencies are timely addressed and resolved. High performers should be recognized and encouraged to continue do what they are doing. Low performers should be given additional training and if no improvement should be asked to be alumni. Again, work smarter and only keep those on the team that are adding value to the organization.
Set Clear Expectations
One of the smartest and easiest things to do to improve performance is to set clear expectations for the staff. This is especially important in revenue cycle when there are numerous functions that are dependent on one another. For example, the authorization team cannot obtain auths without the diagnosis and procedure information gathered from the scheduling team. The financial counseling team cannot see self-pay patients without the registration team communicating when a patient is self-pay. The case management team cannot send requested clinical review information without the notification of admission team communicating what the insurance company has requested. Therefore, setting clear expectations of the staff’s responsibilities is imperative to creating and maintaining efficient operations. When everyone knows what their role is and what they need to be doing, no one has to do someone else’s work. This is working smarter, not harder.
Hospitals that work smarter through investing in technology, embracing LEAN, incorporating quality assurance and training, and setting clear expectations positively impact the revenue cycle. They experience increased productivity, increased employee satisfaction, a lower cost to collect, and maximized reimbursement. All positive impacts to the revenue cycle from working smarter, not harder.
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