What Is Skilled Nursing Facility Revenue Cycle Management

The concept of a revenue cycle in healthcare is very simple. It consists of the collection, analysis and reporting of information from patients to physicians to payers to facilities to assist providers determine the very best practices for each action of the process. Revenue cycle management includes all of these steps and more. It also involves the use of information from all of these steps to determine where the gaps remain in the procedure and how they can be filled.

The secret to enhancing a revenue cycle is to learn what's working and what's not. By identifying locations where the procedure is broken, you can make changes that will enhance the efficiency of the process and eventually increase your profits. Here are some common issues with revenue cycles and how to solve them.

Collection

Numerous facilities battle with gathering the proper quantities of money from patients and their insurance coverage companies. This is especially real if the patient has private insurance or if they are self-pay.

To fix this issue, you need to first understand what the most typical reasons why the facility doesn't collect enough cash. You need to look at the information to see which aspects are leading to under collection. For example, you might discover that a particular percentage of patients never return their documentation. The facility requires to work more difficult to get those patients back to submit the forms once again. On the other hand, you might find that a large number of clients are returning their types late. You need to learn why that is and then make certain that the staff is trained to handle this kind of concern.

Analysis

Once you've identified the issue with collection, you need to examine the information to find out how to remedy it. The first step in this process is to comprehend the reasons why the facility is under-collecting. Once you have that details, you can then take a look at the information to see what can be done to remedy the problem.

If they're not coming back, you require to discover out why. Or maybe the personnel needs to be advised of what is expected.

Reporting

After evaluating the data to identify the problems, you require to learn how to fix them. To do this, you require to recognize the information that is required to keep track of the success of the program. For instance, if you are utilizing rewards to motivate clients to return their types, you require to track how well that is working. You also require to track how much cash the facility is losing because of this concern.

As soon as you have this information, you require to find out what metrics to track. For example, you may want to measure how long it considers the client to return the type after being reminded. Or you may want to look at the number of kinds are actually returned by the patient. After you have the information, you require to figure how to report on it so that you can see what is happening. You may choose that you want to send out monthly reports to show progress. Or you might choose that you desire quarterly reports to tell you what is going on in your facility.

Once you know what to measure, you need to figure out how to measure it. Or you may ask the staff to provide you with a list of all of the patients who never returned the form. This is a list of patients that you need to call and follow up with.

Once you have a plan in place, you require to execute it. That suggests training the staff to utilize the metrics that you have actually picked. Also, you require to set a goal for yourself to fulfill. You may say that you want to reduce the number of patients who never return their forms by 50% within 6 months. If you can do this, you will have increased your revenue.

Conclusion

By following these actions, you will have the ability to increase your revenue and enhance the revenue cycle. You will likewise have the ability to improve the quality of care that you offer to your clients.

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