Below is the initial question:
You have been asked to review the Revenue Cycle for a major Healthcare organization. The leadership team is seeking your recommendations in response to the three questions:
- What is the best method to evaluate Revenue Cycle management performance?
- What factors need to be evaluated to uncover shortcomings and identify areas for potential improvement?
- How are other organizations improving its Revenue Cycle management?
Please provide a response to be below peers, the response should include a follow up question and can also include pictures and graph to further explain the issue.
1st Peer Noel Answer:
According to Nowicki (2015), the average collection period or days in accounts receivable is the most often used method to evaluate revenue cycle management. To ensure accurate and on-time payment, areas of potential improvement include accurate documentation on the part of all healthcare providers, investment in a stable and reliable medical record system with a user-friendly interface as well as enforcing a credit and collection policy whereby an extended payment period would allow for payment in full. In addition to that, hospitals should strive to improve on billing transparency.
It is a good idea for healthcare organizations to look to other companies in various industries for best practices, for example Virginia Mason Medical Center and Toyota production System (JWMI 533, Experts of Practice video). Healthcare organizations have also begun to embrace some aspects of Lean Six Sigma to reduce waste and maximize on productivity.
2nd Peer Tiffani:
What is the best method to evaluate Revenue Cycle management performance?
Revenue cycle is often defined as all the administrativeand clinical functions that contribute to the capture management and collection of patient services revenue. Nowicki outlined revenue cycle as multidisciplinary approach, in accounts receivable by effective managing the production and payment cycles (Nowicki 2015).
What factors need to be evaluated to uncover shortcomings and identify areas for potential improvement?
The most important issues that need to be evaluated to uncover shortcoming would be feedback from the patients/customer. Customer would include providers, pharmacies, insurance companies, anyone who had direct impact with the revenue cycle and process. Through the use of “voice of the customers”, the survey results could be of assistance with how to improve.
How are other organizations improving its Revenue Cycle management?
Several organizations are improving its RCM by implementing “Price transparency”. One of patient’s biggest concerns when going to the hospital or during services is the total out of pocket cost. With price transparency, this provides the customer with the estimated cost up front. Being transparent leads to providing sources for patients to gain the valuable information, therefore development of application are being developed by companies to provide self-service to provide better patient experience.
Nowicki, M. (2015). Introduction to the Financial Management of Healthcare Organizations(6th ed.)