The revenue cycle reboot: 5 insights on the patient-centered RCM

The health system revenue cycle process is in need of a makeover as patients take more responsibility for their bills, and healthcare moves toward a value-based system.


Hospitals and health systems across the country are looking for ways to further digitize and personalize the revenue cycle, mimicking other industries with high consumer satisfaction.

At the Becker's Hospital Review 5th Annual Health IT + Revenue Cycle Conference in Chicago, three panelists discussed the biggest revenue cycle challenges and opportunities in their organizations. The panel, held on Oct. 11, was titled "Top Revenue Cycle Issues Today" and included Patrick McDermott, senior advisor of revenue cycle strategic services at Velocity Made Good Healthcare Consulting; Michele Tynes Napier, chief revenue officer of Orlando Health, and Florian Otto, MD, PhD, co-founder and CEO of Cedar. Dan Nielsen, co-founder and president of America's Healthcare Leaders, moderated the panel.

Here are five key takeaways:

1. Health systems are looking for ways to simplify the billing process and make it easier for patients to pay. It should also be a priority for revenue cycle leaders to personalize the patient billing experience, whether it's an online portal or a text message that will allow patients to use Apple Pay for a quick transaction.

2. Healthcare is becoming more digitized like other industries; for example, you can book air fare, check into your flight, change your seat and order food right from your mobile phone. People are looking for that type of convenience in healthcare delivery, from scheduling appointments to the payment process.

3. Data mining and analysis can help the revenue cycle department predict whether a claim will be denied before it goes out the door. The team can see which diagnosis-related groups and codes are causing denials for payers and stop the claim to work on it before sending it to the insurance company.

4. Patient engagement between the point of service and the bill can be a roadblock. Sometimes it's 30 or 45 days after service before the patient receives their bill, and then they have questions. Health systems are looking for ways to stay connected with the patient during that time, and efficiently answer billing questions. Chatbots can answer common questions and more complex ones can go to humans.

5. Make sure you have the right people in place to answer phone calls about the revenue cycle process. The customer service representatives should be competent and empowered to execute the services patients need to get their billing correct. When possible, take a moment to listen in to a few calls and give positive reinforcement to show that individuals across the revenue cycle and organization are appreciated.

Don't miss the Becker's 3rd Annual Health IT + Clinical Leadership + Pharmacy event in Chicago, May 19-21, 2020. Click here to learn more and register.

More articles on revenue cycle:
5 ways to modernize the revenue cycle
How to get the most out of data analytics
Telehealth strategies for the next 3-5 years

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