RCM tip of the day: Use analytics, intradepartment relationships to address the revenue cycle blind spot

Hospitals should focus on the "blind spot" of the revenue cycle, where independent clinical decisions, changing regulations, complex payer contracts and the business office or billing department overlap, said Robert Corrato, MD, CEO Versalus Health.

This blind spot falls within utilization management as well as other hospital departments. Therefore, data analytic-driven decisions, uniform metrics across departments and intradepartment relationships become essential to managing this area, Dr. Corrato told Becker's

"Hospitals need to devote the same analytical resources and discipline [to the blind spot that] they've applied to all other areas of the revenue cycle. A solution should involve a programmatic approach that includes assessing the issues, identifying opportunities, creating an action plan and consistently monitoring progress," he said.

"The process should involve revenue cycle/finance, compliance, case management, managed care and business office executives. By taking these steps, hospitals can ensure revenue integrity, reduce costs created due to incorrect approaches and improve compliance and private payer performance," said Dr. Corrato.

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.


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