Revenue Cycle Management

When it comes to financial management in the healthcare industry, similar to other fields, the only stable feature is the 'change'. Over the past few years, the ever-changing reimbursement and operational environments have meant that professions are adapted to survive. However, the most imperative modifications ultimately had an impact on the revenue cycle system. Thus, revenue cycle has always required considerable attention at different levels of an organization. New era of revenue cycle management: A challenging issue New era of revenue cycle management has been considered to be the most challenging one that we have come across.

In this case, financial managers need to grapple with DRG rebasing, consumer directed healthcare, price transparency pressure and PPOs. Consequently, the requirement of ensuring excellence in the revenue cycle is profound. Since 2005, KPI (key performance indicator) has been the major concern for most professionals looking after healthcare finance management. Changes in the revenue cycle management over the past few years Over the past 4 years, the atmosphere of revenue cycle management has considerably changed. Now, leaders have become more responsible for functional areas, which weren't covered by original KPIs. The areas include managed care contracting and medical practice management. In addition to that, payments for performance and consumer directed healthcare have become a part of the landscape. In response, best practiced KPIs had to change.

With greater financial risks involved in such cases, group practices and hospitals have completely revolutionized their revenue cycle. This means that they are laying increased emphasis on patient access, scheduling, verification and authorization of insurance, point of service collection, health information management and financial counseling. Performance expectation from such functions has become more demanding and tighter, in response to the enhanced financial pressure. Differences between the KPIs of the past and the current Although they might appear similar, there are significant differences between new generation of KPIs and how they appeared in 2005. The 3 sections, which were not there previously, include managed care contracting, physician practice management and pay for performance. These sections appeared, as most CROs assumed the responsibility of all these functions. Again, their presence was necessary, as it was tough to obtain optimal results, if you were without a comprehensive view of all the functions of revenue cycle.

Furthermore, most of the suggested practice standards were evolving to reflect the changes since 2005, particularly the positive impact of technology on the productivity of the worker. Role of a checklist in revenue cycle management The checklist, which is used with the numeric standards, constitutes an effective and powerful tool for assessing the leaders along with their CFO colleagues of hospital & ambulatory care revenue cycle. In case the financial managers come up with a 'yes' for most of the questions and all the numeric indicators appear good, they are guaranteed to have their revenue cycle operation in good shape. It is imperative that you employ the current trends on managing the revenue cycle, if you wish to achieve beneficial results in a short time.