One RCM Tactic Results in the Highest Increase in Healthcare Revenue

Let’s just say it – healthcare practices need better cash flow and faster revenue reimbursement to continue providing the highest quality of care. But that takes a streamlined, effective, well managed revenue cycle management (RCM) team, which is nearly impossible to maintain with historic staffing shortages and always-changing regulations.

In most practices, the RCM team spends their time focusing on the back-end processes by cleaning up denied claims and contacting payers to submit more information. Their team spends valuable time calling patients asking for balances due.

Practice managers rightly focus on the claim denial rate and days in accounts receivable. While these metrics are certainly important, the true potential for fast revenue growth lies in streamlining RCM front-end processes.

In fact, front-end optimization is the number one RCM tactic for rapid revenue increase. Let’s look at specific strategies and technologies recommended by the experts at Unislink to transform your RCM process, turning it into a powerful revenue engine.

Why RCM Front-End Processes Hold the Key to Growth

Traditionally, revenue cycle efforts have concentrated on fixing issues after the fact – chasing medical claim denials and correcting errors in claims submissions. This reactive approach, while necessary, can be time-consuming and inefficient.

Front-end RCM optimization flips the script. By focusing on prevention rather than cure, you identify and address potential revenue leaks before they occur. This proactive approach leads to several key benefits:

• Increased first-pass claim rates: Clean, accurate claims submitted from the start significantly reduce denials and rework, which saves time and money.
• Faster payments: Faster submissions lead to quicker reimbursements, improving cash flow and financial stability.
• Reduced administrative burden: Streamlined front-end processes free up staff to focus on higher-value tasks, improving overall efficiency.
• Improved patient experience: First-time-right processes minimize the need for patients to revisit billing issues, leading to greater satisfaction.

Now, let’s explore specific tactics and technologies you can utilize to optimize your front-end RCM. When you partner with UnisLink, we provide the tools, implement these tactics, train your teams, and handle all the technology integrations required for a seamless transition to high-functioning RCM operations.

Streamlining the Patient Journey: From Onboarding to Billing

1. Patient Pre-Registration and Eligibility Verification

• Utilize online portals: Implement a secure online portal for patients to preregister, update insurance information, and even pay estimates beforehand. This reduces front desk workload and allows upfront verification.
• Partner with Unislink’s eligibility verification tools: Integrate automated eligibility verification systems to ensure coverage and minimize the risk of denials due to coverage issues.
• Educate patients: Provide clear information about financial responsibilities upfront. This includes estimated costs, accepted payment options, and potential out-of-pocket costs based on patient insurance plans.

2. Streamlining Patient Registration and Intake

• Leverage Unislink’s patient intake tools: Utilize digital forms and pre-populated data based on patient information pulled from insurance verification to minimize data entry errors.
• Focus on data accuracy: Implement robust data cleansing and validation techniques to ensure accurate patient demographics, insurance details, and other critical information.

3. Capture All Charges at the Point of Care

• Train staff on proper coding: Investing in staff training on accurate coding practices minimizes the risk of denials due to incorrect codes or missing information.
• Standardize documentation processes: Implement clear protocols for capturing all billable services rendered at the time of service. This reduces the risk of missed charges and revenue leakage.
• Utilize clinical documentation improvement programs: Invest in programs that support efficient and accurate documentation by physicians, ensuring all necessary details are captured for proper coding.
• Invest in automation tools: Leverage Unislink’s charge capture automation tools, based on predefined rules and clinical documentation, streamlining the process and minimizing errors.

4. Prioritize Patient Communication and Collections

• Offer multiple payment options: Provide patients with convenient payment options like online portals, credit card processing, and flexible payment plans. Unislink can help integrate secure payment options within your system.
• Implement early and clear communication: Send out clear and timely billing statements, along with transparent explanations for charges. This fosters understanding and promotes prompt payment.
• Utilize patient engagement tools: Leverage Unislink’s patient communication tools like text message reminders and self-service portals to gently nudge patients towards timely payments.

5. Develop a Feedback Loop to Prevent the Root Cause of Denials

• Dedicate resources to root-cause analysis: Invest in a resource or resources whose sole purpose is to identify the root cause of denials. These typically lead to front-end processes.
• Categorize Root Causes: Denial root causes typically fall into three categories:
  1. Coverage Issues
  2. Coding Issues
  3. Everything Else
• Implement System and Process Changes:  Implement the system and process changes necessary to prevent the root-cause of denials on an ongoing basis.

UnisLink RCM Technology is Your Revenue Growth Partner 

Technology plays a crucial role in optimizing and streamlining front-end revenue cycle processes. Unislink offers advanced technology and a comprehensive suite of the latest RCM tools and services that empowers your organization to take control of its revenue cycle:

• Automated eligibility verification: Seamlessly verify patient insurance coverage before services are rendered, minimizing surprises and denials.
• Patient self-service portals: Enhance patient experience by providing secure portals for online registration, bill viewing, and payment processing.
• Integrated clearinghouse solutions: Streamline claims submission process with secure and reliable connections to insurance companies.
• Advanced coding and compliance tools: Ensure accurate and compliant coding practices with intelligent coding assistance and automated compliance checks.
• Real-time revenue cycle analytics: Gain valuable insights into your RCM performance, identify trends, and make data-driven decisions to optimize your processes.

Real-time Revenue Cycle Analytics: The Power of Data

Data is the lifeblood of any successful RCM strategy. Unislink’s analytics tools provide you with the insights you need to identify revenue leakage points, measure performance, and track progress. By leveraging data-driven insights, you can:

• Identify trends and patterns: Analyze claims data to uncover trends in denials, payment delays, and other key metrics.
• Measure key performance indicators (KPIs): Track your RCM performance against established benchmarks and identify areas for improvement.
• Predict future performance: Use historical data to forecast revenue and identify potential challenges.
• Optimize resource allocation: Allocate resources effectively based on data-driven insights into workload and performance.

The Unislink Advantage: Your Partner in RCM Success

By partnering with Unislink, you gain access to a comprehensive suite of tools and services designed to streamline your front-end RCM processes and drive revenue growth. Our experienced team of experts will work closely with you to understand your unique needs and develop a customized solution to achieve your goals.

Key benefits of partnering with Unislink include:

• Enhanced revenue cycle visibility: Gain real-time insights into your RCM performance through data analytics dashboards and metric reports.
• Reduced administrative burden: Automate repetitive tasks and free up staff for higher-value activities, with ongoing support from RCM experts.
• Stronger financial performance: Drive revenue growth and improve cash flow with an experienced RCM partner you can count on for your success.

By focusing on front-end RCM optimization and leveraging the power of technology, you can transform your revenue cycle into a powerful engine for growth. Unislink is committed to helping independent physician practices achieve their RCM goals and maximize their revenue potential.

Contact us today to learn more about our solutions and how we can help you achieve your revenue growth objectives.