10 Ways to Stop Revenue Leaks Before They Start

Today’s healthcare financial landscape is complex. Value-based reimbursements, bundled payments, and ICD-10 are changing the revenue lifecycle. As if that weren’t enough, revenue is managed by multiple departments, all of which operate in silos. From patient access to the business office and everything in between, revenue is touched by multiple systems that typically don’t talk to each other.

It’s no wonder healthcare CEOs say they worry most about financial challenges.

Gaining insight into revenue across the enterprise is no easy task. Revenue could be leaking out of the organization and you wouldn’t even know it. The key to identifying those leaks—and stopping them before they start—is having a complete, unified view of your revenue.

Here are 10 ways you can improve your revenue through unified analytics:

  1. Increase point-of-service collections. Verify eligibility, confirm demographics, and fully understand patient portions after insurance, so your registrars can collect payment prior to service.
  2. Understand denial root causes. Denials come from all points of the revenue lifecycle. By linking denial trends to their origins, you can resolve errors and oversights that lead to payer rejections and denial write-offs.
  3. Improve coding and documentation for ICD-10 and beyond. Generating claims that accurately reflect the acuity of services is the first step in ensuring financial viability. Benchmarking identifies documentation variances and pinpoints potential missed revenue.
  4. Educate physicians and coders. Rather than tackling all ICD-10 codes, identify which physicians and coders will be most affected by which codes. Then prioritize coding and documentation specificity for only those areas, departments, and specialties.
  5. Monitor audit risk and reduce take-backs. Improving your financial health isn’t about finding the most revenue. It’s about finding the right revenue. By proactively identifying compliance risk areas, you can avoid revenue take-backs and track the audit appeal process.
  6. Reduce the cost to collect. With the Affordable Care Act, fewer uninsured patients are entering the doors of the hospital. But their copays and deductibles can be high. By identifying each patient’s propensity and ability to pay, you can improve collections and reduce the cost to collect.
  7. Accelerate business office collections. With daily snapshots of revenue data and metrics on AR days, denials, and DNFB coding delays, you can expose AR bottlenecks and optimize collections workflow.
  8. Compare your financial performance to your peers. Powerful benchmarking data enables you to compare aspects of your revenue against current data from today’s peers so you can identify your organization’s weaknesses and quickly spot improvement opportunities.
  9. Embrace new reimbursement models with a single source of truth. As clinical performance becomes a dominant driver in value-based reimbursement, your data can help your clinical and financial leadership come together to align strategies and objectives.
  10. Create action and accountability plans. Once your revenue initiatives are identified, you can create a centralized action plan and assign accountability to ensure your goals are met.

With these steps in mind and with analytics at all points of the revenue cycle, you can evaluate your financial performance in a holistic way. This enables you to see and understand your data in context, create a plan to reduce revenue leakage—and ensure your financial viability today and into the future.

Learn more about how MedeAnalytics can help you gain insight into your entire revenue lifecycle or contact us at info@medeanalytics.com.

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.