Ways to Manage Healthcare Revenue Cycle

The effects of consumerism can be felt by the healthcare revenue cycle in the way that employees focus most of time on containing and reducing healthcare costs in order to cope with the growing financial pressures of the current economic climate. The key to improving access management is through the revenue cycle solutions and responding to healthcare consumerism by accelerating the collection of cash to imrpove the efficiency and speed of the payment of medical bills.

The improvement of access management represents an important area of revenue cycle management. Using the financial clearance solutions for healthcare revenue cycles, allows revenue cycle managers to determine both the insurance eligibility and the ability and willingness of the individual to pay the healthcare costs. This has a great influence on the revenue cycle management in healthcare. A new standard is the consumer self-service which has become part of day-to-day life. The access to a healthcare kiosk and portal has become an expectation in most communities. If clients are able to research healthcare costs, schedule appointments, receive online statements and make electronic payments, medical facilities will be able to respond to the demands of consumers more effectively.

The delivery of McKesson’s healthcare revenue cycle solutions has led to the maximising of revnue capturing, more streamlined billing and the introducing of payment collection using the electronic claims processing.

The revenue cycle is a group of activities in a business and relates to the exchange of services or goods with clients or money. Many business transactions are conduced using a credit basis. After the customer receives the goods, the cash payed from the customer to the service provider. This works as a two phase process: the physical phase in which the goods or services are transfered to the custumer; and the financial phase where the buyer transfers the cash to the company. With health care providers, the revenue cycle payers have been implementing claims, processing financial electronic data interchange, billing collections and analytical systems from a wide variety of health care information technology software vendors in an attempt to keep up with the industry demands of healthcare and to improve thei revenue and turnover

Revenue cycle management has become a job which can pose its own challenges, particularly in the helathcare industry, because a hosptial and medical facility must be able to manage its resources and revenue effectively in order to remain functioning.

Some statistics make the claim that, hospitals are losing 3- 5 percent of their net revenue because of inadequate cycle management. If this statistic is applied to a 300 bed hospital, it means revenue losses of between $4.4 million and $9 million each year.

Two additional reasons for bad debt could be the low self-pay collections and insurance denials which are easily quantifiable. The lost charges, delayed payments, underpayments are more difficult to quantify.