Here are seven revenue cycle management tips from industry experts, published by Becker's Hospital Review since June 4.
1. "By proactively scrubbing claims using machine learning, providers can head off potential issues by comparing current claims to previous patterns of denials. They can then make corrections, such as improving coding accuracy, before claims are submitted rather than after, helping improve cash flow as well as significantly reducing the cost of reworking claims." - Deepti Sharma, director of product management at HSBlox
2. "When a big acquisition or merger occurs, plans must be put into place to accelerate the provider onboarding/integration process. Tax identification numbers, lockbox services, and provider data must be integrated along with the ability to link providers from 'hospital A' to contracts with the insurance companies at 'hospital B.' Strategic decisions must be made on how to best manage provider data." - Scott Friesen, CEO of Newport Credentialing Solutions
3. "Hospital CFOs can benefit from working closely with their hospital-based physician groups practicing radiology, pathology, ED, etc. in all matters related to billing, collection and contracting. These physicians and their own RCM teams know the intricate details about coding, billing, prior authorization and documentation best practices related to their own individual specialty." - Rebecca Farrington, chief revenue officer at Healthcare Administrative Partners
4. "Where's my remit? is the question most often asked by RCM leadership. Today, this inquiry can be answered with greater precision via predicative analytics using machine learning. Machine learning utilizes algorithms to predict future payments based on when past remits were paid. The algorithms use payments made by payer, claim type and a number of other factors that, when combined, create a historical pattern to predict future payments." - Eric Nilsson, chief technology officer of SSI Group
5. "When it comes to denials management, develop a strategy with attainable goals to help your team be more successful. Review your personnel, technologies and processes and identify areas that need improvement. It's critical to provide guidance to help your team successfully tackle their work list or work queues. Providing a spreadsheet and saying 'go for it' simply isn't enough." - Kareem Aqleh, vice president of revenue cycle for Wound Care Advantage
6. "Physicians need to not only understand what to code, but also what to document. Make sure you have a charge-reconciliation protocol, which captures all services performed by your practice and bills them appropriately. Create a closed-loop process to ensure charges are billed for every service." - Tom Romeo, general manager of healthcare IT at Quest Diagnostics
7. "While it may seem counterintuitive to discontinue use of RCM solutions or processes that 'worked' as separate systems, this is an example of a time when less is definitely more. A strategic partnership with a single RCM service provider can improve efficiencies, staff experience and financial outcomes." - Allen Latham, vice president of revenue cycle management at TriZetto Provider Solutions
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