Want to Improve Revenue Cycle? Improve Healthcare Billing

When you set out to become a healthcare provider, you probably didn’t anticipate that every practice owner could benefit from a business degree. But the fact is your practice is a business. For practice owners, that means understanding and monitoring the revenue cycle is imperative to sustaining and growing that business. To be successful, in part, means identifying the obstacles to faster payments and finding ways to leverage tools and technology to help improve the process.

For many practices, managing the revenue cycle means staying on top of healthcare billing and working with both insurers and patients to ensure payments are received on time. Thankfully, there are tools to help you both manage the process and simplify billing for patients as well.

Quick Links

• Revenue Cycle Challenges for Healthcare
• The Role Of Healthcare Billing In Revenue Cycle
• How Patient Experience Impacts Healthcare Billing
• Improve Healthcare Billing to Improve Revenue Cycle
• Make the Healthcare Payment Experience Convenient for Patients

Revenue Cycle Challenges for Healthcare

When it comes to healthcare, the revenue cycle refers to the entire process of managing patient service revenue, from the initial point of patient contact to the final payment received. Despite the critical nature of this cycle, healthcare providers face numerous challenges to claims and billing impacting their ability to optimize and streamline the revenue cycle.

Perhaps one of the greatest challenges of the healthcare revenue cycle is the complexity of healthcare billing and coding. With a wide variety of insurers, regulations, and payer policies, the end result is often complicated billing and coding requirements.

Similarly, inaccuracies in coding can result in claim denials, delays in reimbursement, and revenue leakage. Keeping up with the constant changes in medical codes, dental codes, and cross-coding presents an ongoing challenge and often requires dedicated resources for both compliance and accuracy.

While changes in coding create challenges, so do changes in healthcare policies and procedures. More specifically, the continuing trend of high-deductible health plans increases billing pressures on providers as insurers shift financial responsibility for treatment and care to patients.

This is particularly challenging as patients are often unaware of changes or do not fully understand their coverage. As a result, healthcare providers must balance collecting payments while maintaining the positive patient relationships that improve both patient care and practice growth. 

Increasingly, these challenges come down to how your healthcare practice understands your payer mix and handles healthcare billing. For most healthcare practices, a majority of revenue may come from insurance claims, but that leaves the rest to your patients. And, if like most healthcare practices, improving your net collection ratio is a goal, then looking at your patient billing is as important as insurance claims. 

Looking for tips on billing and claims? Check out the video below

The Role Of Healthcare Billing In Revenue Cycle

At the core of the healthcare revenue cycle lies healthcare billing which includes creating and submitting claims to insurance providers as well as billing patients for what those providers do not cover.

Healthcare billing, however, does not start after the patient has been treated. Instead, the process begins prior to their first appointment with the collection of insurance information, crucial for submitting accurate claims as well as helping patients understand their out-of-pocket costs and obligations.

Post-care procedures and diagnoses are documented, relying on medical codes, such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes or Current Dental Terminology (CDT) or ICDT-10 which is medical cross-coding for dental. These codes are intended to ensure uniformity and clear communication regarding the procedures or treatments provided. In turn, that enables an insurance provider to determine coverage.

As noted above, this is among the first place healthcare providers may incur an obstacle. If all things go smoothly, a claim is accepted and paid, but if there is an issue with the claim, ranging from inaccurate or incomplete information to incorrect coding, the claim may be denied. In that case, the revenue cycle is extended as the claim will need to be resubmitted, at cost to the healthcare provider.

Obviously, finding ways to shorten the cycle should be paramount, so reducing claim denials is often an important goal for a healthcare practice.

Then, the insurance payment must be posted and the patient billed for any remaining amounts. When it comes to patient billing, there may be reasons for delay here as well, from inaccurate patient account information and slow manual billing processes to patient difficulties in paying due to financial hardship. As a result, some healthcare providers may experience even further delays in receiving payment in full.

Because of the inherent challenges in healthcare claims and billing, it can sometimes be difficult to determine the actual revenue cycle, but one thing is certain, finding ways to decrease delays and streamline the process is essential for a practice’s financial health.

How Patient Experience Impacts Healthcare Billing

In technology, it’s often discussed how a positive user experience (UX) on one’s website or with a business' digital presence can build and nurture a relationship with a potential or existing customer. The same holds true for patient experience and healthcare billing.

As mentioned earlier, patient billing can create challenges for a practice’s administrative staff.  A positive patient experience, after all, is shaped by all of the interactions your patients have with your staff. Navigating both care and billing (or collections) can sometimes be difficult and create unnecessary friction.

But, patient experience goes beyond that as well. There are two additional factors related to healthcare billing and patient experience. The first of these is communication.

With insurance verification prior to any appointment, your team should be able to communicate a patient’s full financial obligation prior to treatment. This way, a patient understands what their expenses will be and can properly prepare to handle any bills. Failure to communicate this upfront can create significant problems in the end, impacting not just your patient relationship but also your revenue cycle.

Make the Healthcare Payment Experience Convenient for Patients

One of the most critical things you can do to improve patient experience and your revenue cycle is to  make patient payment simple and secure. These days, most Americans live busy lives and find themselves running between obligations with little time left for trips to the post office, bank, or even to your office to make payment. In addition to time constraints, many Americans are worried about submitting online payments to small healthcare practices and potentially exposing their bank accounts or credit cards online.

Simplifying the payment process is key to collecting. If you can connect with your patients on the platforms and digital payment methods they’re already using, you’ll increase the likelihood of a faster payment. Additionally, receive payments quickly and improve revenue management by:

• Centralizing billing activity and insights in one platform
• Connecting with major digital wallets for easy patient payment
• Creating custom messaging for valuable patient touchpoints 

In other words, finding ways to save your patients time and give them peace of mind when it comes to making payments can help not only streamline payments and shorten your revenue cycle, but it can also help provide a positive experience for your patients.

Improve Healthcare Billing to Improve Revenue Cycle

Efficient healthcare billing is essential for optimizing the revenue cycle, reducing the accounts receivable days, and enhancing the financial health of your healthcare practice. Continuous monitoring, periodic audits, and the use of technology to streamline processes are integral components of successful healthcare billing practices. A key way to increase patient satisfaction and timely payments is to implement an easier payment process for patients. The flip side is dealing with dissatisfied patients who are more likely to delay payment. Further, those same patients are more likely to complain (both to your team and others) which can impact your overall efficiency and revenue. 

Providers must, therefore, invest in advanced technologies, ongoing staff training, and efficient processes to navigate the complexities of billing and coding, address shifting payment dynamics, and leverage technology to assist with these efforts.

Further, practices that seek to improve their healthcare billing will simultaneously see improved productivity from staff who are now freed up from traditional payment processing to handle other components of patient care.

Healthcare billing doesn’t need to be a burden for either you or your patients. With the right tools and the right support you can improve the process for all parties. Dental practices can first ensure their patients are aware of their out-of-pocket expenses through automated dental insurance verification. Then work with billing and claims experts to understand your Accounts Receivable (A/R). And, finally, leverage payment technology to help patients painlessly pay their balances. . 

For all healthcare providers, you can simplify the payment process by leveraging existing technology to seamlessly deliver HIPAA compliant and secure billing statements to your patients. In addition, you can receive payments via digital wallets and payment systems with whom your patients are already familiar and comfortable.

It’s time to take action to improve your business. If you’re ready to discover the future of healthcare revenue management and improve your healthcare billing and payment process, get in touch with the iCoreConnect team today to discuss our newest product to help drive your revenue, iCorePay.

Want to learn more? Check out these tips from the iCoreConnect Team!