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Healthcare facilities can cut costs by assessing their revenue cycle for opportunities to optimize processes and workforce. Ensure your technology is optimized and used to the fullest of its capabilities. Improve supply chain, streamline management structures and improve patient throughput.

The stages of the revenue cycle are as follows:

Front End: Patient Access (Insurance Verification, Pre-authorization) 

Middle: Service Delivery (CDI, Charge Capture, Coding) 

Back End: Receivables Resolution (Claims, AR Follow Up and Denials Management, Collections)

Each stage of the revenue cycle is important and necessary but there are imperative tasks for timely, optimal reimbursement. 

• Pre-registration: accurate patient information should be collected, and all prior authorization determinations made. Patient financially cleared for point of service. 
• Point of service: collect patient portions for service including copay or self-pay balances 
• Claim submission: appropriate codes supplied on patient claim along with all necessary documentation to support 
• Claim follow up: any factor could cause the payer to deny the claim. Follow up is important to determine correction or appeal. 
• Patient liability collections: providing accurate statements and follow up for collection of payment balances. If it turns to bad debt (generally over 120 days), it is imperative to follow state guidelines and regulations for compliant collections.  

• Put the patient at the center of the process.  
• Collect patient responsibility prior to services rendered.  
• Ensure you have exhausted the search for coverage for uncompensated care.  
• Optimize your chargemaster as it’s foundation for all charges.  
• Ensure accurate and appropriate coding. 
• File claims in a timely manner.  
• Manage/prevent denials.