According to the Healthcare Financial Management Association (HFMA), revenue cycle is defined as "all administrative and clinical functions that contribute to the capture, management and collection of patient service revenue." It includes processes and procedures that can impact a healthcare organization’s revenue including scheduling, patient registration and accounts, payment collection and anything that has to do with accounts receivable (A/R). I like the way Ryan Mcaskill of revcycleintelligence.com described it when he wrote, “it is a healthcare organization’s financial circulatory system.”
Although revenue cycle management (RCM) has been part of healthcare for many years, some healthcare organizations are only recently utilizing their EHR system along with it to improve their financial and operational performance. Some may not even realize their EHR includes RCM capabilities such as real-time insurance verification, electronic check-in, price estimators, and more. This integration of systems is especially important because each part of the continuum of care can have an effect on a healthcare organization’s revenue cycle.
Hospitals may find it difficult to alter from processes that have been in place for years because they work. The challenge is that while existing processes may be tried and true, they are often cumbersome, consume a large number of resources, and are prone to human error. Implementing the RCM features offered by your EHR can offer great value, and in my opinion, are well worth the effort. Following are some benefits that can be achieved through EHR/RCM integration:
- Streamlined coding and claims processes/reimbursement
- Faster reimbursement through electronic claims and attachments
- Reduction or elimination of incomplete claims
- Increased patient safety and reimbursement
- Report generation for outstanding claims/patient balances
- Reduced paper waste, filing time and wait times through Electronic Signature Captures saved to the EHR
- Expedited cash flow
- Improved staff productivity and reduced human errors
- Secure, online access for patients to their records through patient portals
- Time saving by using insurance verification tools
- Increased patient satisfaction through price estimation tools
- Identification of areas in the cycle that need improvement
- Faster patient registration through electronic check-in
- Minimization of manual input with EHR charge capture
- Quicker and easier collection of outstanding balances through credit cards on file
Healthcare organizations that use many of these tools show more accurate documentation and are able to capture their costs in a more streamlined manner. Again, sometimes it’s a matter of using tools already included in an EHR rather than having to purchase a whole new system. Though it’s still important to adhere to set policies and procedures when integrating EHR and RCM capabilities, doing so should result in a higher ROI and improved patient care.
Our team at Syntrix has been developing Revenue Cycle analytics solutions for over a decade. We understand that building revenue cycle processes on a solid, reliable foundation is essential for long-term success. We like to empower our customers to access the reports they need to achieve optimum functioning, and help define and develop analytics solutions so you can use your EMR technology to get the most out of your revenue cycle data. Contact us today.
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