This article explores one of the most interesting questions that
hospitals should be asking themselves? How much are missed follow-ups
costing you? and How could Revenue Cycle Management help?
This article addresses strategies to improve revenue, improve care transitions and achieve better patient outcomes and hospital performance. Transitions in care occur as patients move from one facility to another and from one provider to another. Most commonly, this refers to discharge from the hospital to any less acute care setting or discharge from a rehabilitation center to home as a patient recovers from acute illness or injury. Risks of care transitions include adverse drug events, symptomatic worsening, hospital readmission, and missed follow-up. Patients with depression and substance abuse, multiple prior hospitalizations, and complex medication regimens are at highest risk for readmission. We need to get the patient back in our facility.
Take this simple equation and extrapolate: (500 total patients -175 returned for follow -up = 325 did not)
What other types of Revenue are hospitals missing out on?
Hospital-based physicians encounter several challenges with capturing revenue typically experienced by office-based physicians. Integration with the hospital patient accounting systems and business office can create issues resulting in longer days in A/R, increased bad debt and lost revenue.
Hospital-based physicians are the anesthesiologists, emergency physicians, hospitalists, radiologists, pathologists, neonatologists and others who treat patients in an inpatient setting. In general, these physicians aren't employees of the hospitals in which they work. For billing purposes, they often use a remotely located billing staff or outsourced company.
Revenue Cycle Management Challenges for Hospital-Based Physicians
These physicians also use the hospital's computer systems. If the hospital-based physicians work in more than one hospital, they're using different systems. These disparate IT systems increase complexity and make revenue cycle management more difficult. For example, a significant gap can exist between when the hospital-based physician treats a patient and then bills for the service.
Furthermore, the hospital's IT systems are geared to those things that enhance hospital revenue, not professional fees for physicians. In many cases, these physicians are on their own in terms of billing and revenue cycle management.
Another challenge in this scenario is the paper-based hospital. If physician documentation is paper-based, are more time-intensive to manage and are more prone to errors. And, correcting these inefficiencies is a major undertaking. These compounded issues greatly affect revenue cycle management.
Finally, some charges may be missed for the hospital-based physician. It's not uncommon to have under- and over-coding. Coding errors can have a negative effect on revenue cycle management. To correct the errors, physicians or their consultants must have a comprehensive knowledge of the numerous billing rules.
How to Improve Revenue Cycle Management for Hospital-Based Physicians
Even with these substantial challenges, certain steps can be taken to improve coding accuracy and workflow efficiencies. For example, fee coding should be done electronically so it can go directly into a billing system. By doing this, hospital-based physicians enhance their revenue cycle management.
They reduce the risk of lost revenue and getting audited. Charges for professional fees are more accurate. It also slashes the time between incurring the charge and billing for it. Plus, using this type of revenue cycle service helps prepare hospital-based physicians for ICD-10 coding.
One sure-fire way to improve revenue cycle management is to use the services of an experienced healthcare consultant. These healthcare solutions providers have the expertise and tools to improve processes. They are experienced in transitioning from paper documentation to electronic health records and optimizing workflows.
Healthcare solutions providers can shorten the revenue cycle by developing systems to electronically capture codes and pass data to the physician's billing systems. These process improvements also reduce data entry work. By enhancing revenue cycle management, hospital-based physicians can improve operations without major disruptions to providing their services.
This article addresses strategies to improve revenue, improve care transitions and achieve better patient outcomes and hospital performance. Transitions in care occur as patients move from one facility to another and from one provider to another. Most commonly, this refers to discharge from the hospital to any less acute care setting or discharge from a rehabilitation center to home as a patient recovers from acute illness or injury. Risks of care transitions include adverse drug events, symptomatic worsening, hospital readmission, and missed follow-up. Patients with depression and substance abuse, multiple prior hospitalizations, and complex medication regimens are at highest risk for readmission. We need to get the patient back in our facility.
Take this simple equation and extrapolate: (500 total patients -175 returned for follow -up = 325 did not)
What other types of Revenue are hospitals missing out on?
Hospital-based physicians encounter several challenges with capturing revenue typically experienced by office-based physicians. Integration with the hospital patient accounting systems and business office can create issues resulting in longer days in A/R, increased bad debt and lost revenue.
Hospital-based physicians are the anesthesiologists, emergency physicians, hospitalists, radiologists, pathologists, neonatologists and others who treat patients in an inpatient setting. In general, these physicians aren't employees of the hospitals in which they work. For billing purposes, they often use a remotely located billing staff or outsourced company.
Revenue Cycle Management Challenges for Hospital-Based Physicians
These physicians also use the hospital's computer systems. If the hospital-based physicians work in more than one hospital, they're using different systems. These disparate IT systems increase complexity and make revenue cycle management more difficult. For example, a significant gap can exist between when the hospital-based physician treats a patient and then bills for the service.
Furthermore, the hospital's IT systems are geared to those things that enhance hospital revenue, not professional fees for physicians. In many cases, these physicians are on their own in terms of billing and revenue cycle management.
Another challenge in this scenario is the paper-based hospital. If physician documentation is paper-based, are more time-intensive to manage and are more prone to errors. And, correcting these inefficiencies is a major undertaking. These compounded issues greatly affect revenue cycle management.
Finally, some charges may be missed for the hospital-based physician. It's not uncommon to have under- and over-coding. Coding errors can have a negative effect on revenue cycle management. To correct the errors, physicians or their consultants must have a comprehensive knowledge of the numerous billing rules.
How to Improve Revenue Cycle Management for Hospital-Based Physicians
Even with these substantial challenges, certain steps can be taken to improve coding accuracy and workflow efficiencies. For example, fee coding should be done electronically so it can go directly into a billing system. By doing this, hospital-based physicians enhance their revenue cycle management.
They reduce the risk of lost revenue and getting audited. Charges for professional fees are more accurate. It also slashes the time between incurring the charge and billing for it. Plus, using this type of revenue cycle service helps prepare hospital-based physicians for ICD-10 coding.
One sure-fire way to improve revenue cycle management is to use the services of an experienced healthcare consultant. These healthcare solutions providers have the expertise and tools to improve processes. They are experienced in transitioning from paper documentation to electronic health records and optimizing workflows.
Healthcare solutions providers can shorten the revenue cycle by developing systems to electronically capture codes and pass data to the physician's billing systems. These process improvements also reduce data entry work. By enhancing revenue cycle management, hospital-based physicians can improve operations without major disruptions to providing their services.
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