Handling Revenue Cycle Management (RCM) at DRH Billing Services

RCM Solutions

In the health care industry RCM is the primary key to boost up the revenue. DRH takes every necessary solution to develop the RCM process at an increasingly rapid pace. Our new applications and systems have helped streamline many administrative processes, particularly as they relate to revenue cycle management (RCM). With our latest technology, hospitals can more easily and efficiently capture charges and coordinate care, and often the challenge is implementing those systems and processes in the first place. The logistical hurdles of rolling out new solutions are multiplied when implementation has to occur across large healthcare networks that consist of dozens of practices. In such cases, each individual hospital could potentially be using different systems and processes to capture charges, which makes it difficult to get everyone on the same page and ensure a smooth transition.

Selecting the right Billing Company is a critical step to optimizing workflows and RCM, and the challenges don’t end after go-live. Our solution for this is to leverage a dedicated implementation team that can analyze how different levels of an organization use software solutions and provide recommendations that will ensure increased adoption rates, timely billing and a reduction in missed charges.

Here is a rundown of a few key areas that large health systems and their implementation teams should be prepared to address as they consider rolling out a new RCM solution.

• Planning & Implementation
• Revenue Cycle Data Analytics
• Post Go-Live Optimization And Training

Planning & Implementation

Many software implementations experience low adoption rates – or even outright fail – due to a lack of sufficient resources dedicated to change management, which encompasses everything from developing an implementation strategy to educating key stakeholders within the organization. This is especially critical for larger enterprises coordinating a rollout across several practices, where implementation strategies will have to be adjusted to account for varying workflows and reporting structures.

A billing company that has a dedicated change management team, which could be an in-house team or outsourced through an external partner, typically starts by thoroughly analyzing practice structures to understand how a new IT solution will disrupt workflows. These audits can be accomplished through interviewing clinicians, administrators and billing staff or shadowing them over the course of a typical day. By documenting current workflows, procedures and systems, the team can more easily identify potential obstacles to implementing a new IT solution and develop a strategy for overcoming them. Recommendations for overcoming these roadblocks should serve as the basis of a change vision that can be shared with practice leadership and implementation teams. This comprehensive approach takes time, money and resources, and healthcare organizations that prioritize change management and pre-implementation planning will see a higher adoption rate and return on investment.

Revenue Cycle Data Analytics

Once the new RCM system is up and running, it’s critical to monitor the performance metrics so health systems can identify how many practices are adopting the new technology and, more importantly, understand whether the practices that have adopted the system are correctly using it. Some health systems may view a high adoption rate as the ultimate measure of success, but a truly successful implementation will see the new solution having a tangible, beneficial impact on hospital workflows with corresponding improvement across key performance indicators (KPIs) such as charge lag, claims denials and average reimbursement rates.

In addition to reviewing its own metrics and KPIs, a health system should compare its performance to industry standards. This provides an objective level from which the organization can benchmark whether its workflows are performing as well as they could be. From here, the implementation team can use the findings compiled from conducting audits of practice workflows to identify what may be causing any performance shortcomings reflected in the KPIs.

Post Go-Live Optimization and Training

With the analytics supplied by the new RCM solution in hand, the implementation team can identify shortcomings in workflows and revenue cycles. In some cases, these shortcomings are a result of clinicians and administrators incorrectly using the new application. They simply need to be taught the best ways to use the new solution to facilitate improvement in those problem areas. Each department within a hospital will use the RCM solution in a different way, so it’s essential to tailor education for each team so they understand the optimal way to utilize a new system after it goes live.

An implementation team can tackle this task by developing a visual guide that emphasizes the features and functionalities most relevant to a particular department. Such a guide can be thought of as a playbook customized to empower various teams, from care and billing teams to compliance and administrative leadership, to get the most out of their new platform. Through this approach, each of the teams in a health system can contribute to a coordinated effort that maximizes use of the solution and optimizes revenue cycle management.

The problem for many health systems is that IT solutions are under-utilized after rollout due to restraints on time and other resources necessary to ensure successful implementations. No matter whether a health system builds its own implementation team internally or taps the expertise of a vendor, it’s critical to ensure the pieces are in place to proactively address pain points in revenue cycle management.

Read More: One Stop RCM Solutions – Cut down operations cost (Remote Medical Billing)


 

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