What do industry leaders like Gastro Health, Vision Innovation Partners, and US Dermatology Partners have in common? They’ve implemented technology and processes that build off their team’s billing and coding expertise. Let’s look at how you can leverage your team’s knowledge to create your own well-oiled RCM machine.
Identify Top-Performing Staff
As you begin to scale operations post-acquisition, look at the team responsible for the daily coding and billing processes. This staff has unique knowledge of what it takes to navigate each step of the revenue cycle. As with any group, there will be those who better understand the complex rules involved in getting your claims paid. Bring those individuals together to create a center of excellence for your RCM staff. Identifying the leaders now will be invaluable as you work to standardize the charge review and coding processes.
Turn Knowledge into Customized Rules
Now that you have identified your core RCM team, begin compiling their knowledge to turn it into customized rules. Not only will they have documents that track the ever-changing insurance requirements, but they will also know what it takes to get your specialized services paid. Leverage these top knowledge sources into a small governance committee that can meet monthly to review denial trends, consolidate data, and implement additional rules. By continuously reviewing this type of data, your team can adjust existing rules and create new rules that meet the demands of the revenue cycle.
Create a Centralized Knowledge Repository
Having a dedicated, top-notch team creating custom rules will have a bigger impact once you have a central location where all staff can access that information. Using technology that verifies all charges against your rules will ensure consistent performance for all coding and billing staff. It is like cloning your top performers – clean claims will steadily be going out the door with less training and manual work required.
Implement Change Throughout the Revenue Cycle
The revenue cycle is just that – a full circle. And having a weak point in that cycle can affect performance and your bottom line. Using technology that harnesses your team’s expertise improves the success of all teams in your cycle. Automatically reviewing 100% of charges entered into the EHR before they reach the PM system will identify and correct the disparate data coming out of the EHR and improve the clinical experience. Eliminating the need to constantly fix routine billing problems allows staff to get charges out the door faster and reduces work for A/R staff. And sharing denial data with your governance committee will ensure they keep the custom rules updated. From clinical care to finance, everyone plays a part in keeping your cycle moving.
“We do employee satisfaction surveys every January and July. Once we implemented RCxRules we saw a 24% increase in employee satisfaction. Our goal is a 75% net promoter score and we’re currently at 83%. We’ve seen employees go from feeling totally overwhelmed to feeling secure and satisfied in their roles. It's a win for us in terms of productivity, and an obvious win for our employees’ wellbeing.”
RCxRules – Turning Knowledge into Revenue
We have experience helping leading PE-backed medical groups optimize their RCM operations. Ready to discuss how leveraging your team’s expertise can amplify RCM performance?