6 Tips for Building a Patient-Centric Revenue Cycle

In a previous blog post on adopting a patient-centered approach, we discussed the benefits of that approach to care, as it can help reduce costs, build patient-provider relationships, improve outcomes, and more! Patient-centricity refers to the design of treatments, clinical trials, or alternative health solutions for specific individuals. It allows patients to align their care around personal preferences and empowers them to take charge of their own health. In addition, providers can copy this approach, make their revenue cycle more patient-centric, and double down on the benefits! Here are six tips on how to make to build a more patient-centric revenue cycle.

1. Ensure Bills Arrive On-Time

There are many things that can go wrong if you keep your patients waiting on their bills. The waiting could make them forget about the bills, no longer have enough money to pay them back, or cause unwanted stress, damaging the patient-provider relationship. The goal of any practice should be to get bills out the door as quickly as possible, and the creation of the bill should begin in the room with the patient, at the point of care. The patient and the medical scribe/administrator need to ensure that all the insurance information is correct, and the encounter satisfies all billing requirements.

By taking care of the insurance and billing information beforehand, staff can send bills electronically or by mail within hours, rather than days of the appointment. This action will speed up the accounts receivable cycle, minimizing wasted days that drain your hospital or practice’s revenue. ¹

2. Clear Communication

People like surprises when it comes to a birthday party or a gift, but not when it is a charge on their medical bill. Communication is a key component of a patient-centric revenue cycle. Many practices create a document detailing all-payer information, including copayments, co-insurance, and deductibles, to minimize confusion.² At the very least, providers should set aside a time to explain to them what is going to be included on the bill, whether it is a medication they prescribed, a test that the doctors ran, or another alternative procedure. If the patient looks at the bill for the first time a few days after the incident/appointment and sees something he/she/they has a question about, the patient will most likely call about it, leading to delays for you and your practice. If the patient is unsatisfied with your answers, he/she/they may refuse to pay it completely, causing more unwanted problems.

Getting billing information out in the open early will not only help increase patient satisfaction but keep the revenue cycle up to date.

3. Patient Education

Most patients do not have a good understanding of how the billing cycle works. According to a 2018 survey, about half of patients did not pay their bills in full due to a negative billing experience.³ This is detrimental to the revenue cycle for obvious reasons. Implementing a patient education or financial counseling program is a great way to manage your patients and ensure you receive the full payment. Your team of experts will engage them in financial conversations, lay out different payment options, and set up a plan that works for both the patient and your practice.

Patients should know their financial responsibility even before they walk in the door. Some practices offer pre-service patient education meetings where they give a rundown of the basic information and processes, such as confirming eligibility and insurance verification.

4. Easy Payment Options

Although multiple invoices may sometimes be unavoidable, providers can minimize complications by combining their payment channel onto one single platform. Imagine being admitted into the hospital and receiving care from multiple entities, then being billed separately in different formats, languages, and payment options. Something is bound to go wrong. One particular white paper examined how one medical center in Georgia realized $100,000 in operational cost savings by consolidating patient payment vendors and adopting self-service payment methods.¹

Every industry from shopping to banking is moving online, and healthcare finance should be no different. In fact, a recent study showed 83% of people want to pay their bills online.⁴ By setting up email- and text-based invoices that can be paid with a single click, your practice can make things easier for itself and your patients.

However, simply having an online presence is not enough these days. In addition to making payments, patients should also be able to schedule appointments, visit their portal, access a virtual provider, and many other processes on the web. Leadership must design their revenue cycle workflow in a way that allows the patient to have a smooth experience. It is the same reason people love shopping on Amazon; it is a one-stop shop for everything you need.

5. Leverage Metrics

Businesses from healthcare organizations to professional sports teams use analytics to enhance operations. As previously stated, patient satisfaction can drastically impact the revenue cycle, and practices can gain a lot of insight by analyzing patient tendencies. There are several financial, operational, customer service, and quality metrics for this, such as online portal usage, claim denial rate, call waiting time and abandon rate, charging lag, etc.⁵ For example, when leadership notices that call abandonment rate is up, it may be time to hire new administrative staff members to limit the amount of time patients are on hold. If they notice patients are not utilizing the payment portal, they can alter the design and make it more user-friendly. Patterns of negative metrics will enable practices to make the necessary changes and improve their organization.

6. Avoid Denials

Nothing hurts your practice more than claim denials. In simple terms, denials occur when the insurance company refuses to pay for an individual’s healthcare service. Although the nationwide medical claim denial rate is around 18%, nearly 90% of them are preventable. The first two things doctors, and front office staff need to do is make sure all patient health and financial information are correct, and that their insurance policies show coverage for the specific procedure the doctors performed. To avoid denials, all it takes is a little extra effort, and perhaps a good Revenue Cycle Management tool. For more on claim denial prevention, head to one of our recent blog posts.

Technology has caused patients to think like consumers, and if they do not like your services, they can easily go elsewhere for medical help. Doctors should not wish their patients to fall ill again, but if they unfortunately do, you want them to get treated at your facility. A successful transition to a patient-centric revenue cycle will result in both staff and patient satisfaction, and by giving them a positive experience from admission to billing, they will not only come back, but they may even recommend your site to others, and there is no better way to bring in revenue than from word-of-mouth marketing.

Convergence Business Office powered by Optimum offers a smarter way for your hospital to serve patients with better workflow automation and financial results. It offers predictive denial management, the ability to exchange data intelligently and securely, and stays on top of the ever-changing government regulations. In 2019, Black Book named Optimum RCM the “Highest Client Satisfaction” for Revenue Cycle Management and Enterprise Resource Planning Software.

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REFERENCES:

1. “Revenue Cycle 8: The Patient-Centric Revenue Cycle.” HealthChannels, 26 Apr. 2016.
2. “Tips for Creating a Patient-Centric Revenue Cycle.” DreamSoft4U, 22 Oct. 2020.
3. Heath, Sara. “How Patient Experience in Billing Offices Impacts Patient Payments.” PatientEngagementHIT, 15 Oct. 2018..
4. “New Study Reveals 83% of Consumers Want to Pay Bills Online.” NTC Texas, 26 Dec. 2019.
5. “How to Create a More Patient-Centric Revenue Cycle.” Mnet Health, 30 Mar. 2021.