Maximize your revenue in the new year

Maximize your revenue in the new year

Accurate billing and reimbursement are important for making sure skilled nursing providers deliver quality care while also receiving adequate compensation. But right now, organizations are at a tipping point, running on razor-thin margins, looking for ways to optimize current collections, and facing ongoing cuts to Medicare and other government-funded programs.

Maximizing revenue requires an expert team that understands the coding process and communicates consistently to make sure your facility is properly reimbursed for the high-quality care you provide.

Streamline your billing process for faster reimbursement

Nursing home leaders are always looking for ways to improve their facility’s bottom line, and focusing on your revenue cycle management (RCM) process can be a good place to start. Having a team that stays on schedule and up to date on coding and billing changes keeps important tasks from falling through the cracks and can help you avoid delays in care and billing. A schedule for conducting reviews of aging accounts and claims also helps identify potential problems so they can be addressed.

Use RCM technology to improve efficiency and accuracy

RCM technology can be a powerful ally to streamline the revenue cycle. Tools that automate workflows and leverage analytics can help SNFs improve efficiency and accuracy while reducing errors and improving reimbursement.

Using analytics to regularly review the health of your revenue cycle and to track and trend progress can show areas where improvement will streamline the billing process for faster reimbursement. In addition, a fully integrated EHR that allows clinical data to seamlessly flow into billing and reimbursement systems saves time and money by reducing errors and improving efficiency. 

Using technology to its fullest potential is one key to optimizing the revenue cycle for skilled nursing facilities. Built-in RCM workflows help maximize reimbursement and streamline the billing process. Another feature to leverage is work-to-zero task lists, which help make sure all tasks are completed accurately and on time. This frees providers to focus on areas requiring attention and not on issues already on track, so more time can be spent with residents.

Stay in communication with payors and patients alike

Verifying insurance and coverage information for each patient is critical. This should be done early on and be a continuous process throughout the patient’s stay. Billing the correct payor, and knowing that  payor’s billing requirements, guarantees that your facility receives payment for services.

Sharing billing and coverage information with patients and their families is essential, so they will know about any eligibility changes and their responsibility for costs. All billing policies, payor coverage responsibilities, and schedules should be documented and communicated to patients, responsible parties and appropriate family members.

Set goals for improvement and commit to ongoing evaluation

You should regularly evaluate your RCM processes to make sure they’re supporting organizational goals. Monitor and review patient outcomes using analytics to ensure you’re making progress and look for opportunities to improve patient care while reducing costs. Focusing on goals helps you deliver quality care, which in turn helps generate the revenue needed to sustain and grow your organization. And as always, critical thinking and creativity are key in developing new approaches and solutions.

Make sure the EHR experts in your organization stay current on new features and functions to  maximize reimbursement and ensure new and existing employees are adequately trained on your EHR. Helping everyone take full advantage of the technology you have in place helps streamline workflows, improve employee job satisfaction and support high-quality of care. 

The financial and regulatory aspects of skilled nursing are growing more complex. Having a team dedicated to optimizing your organization’s revenue cycle can be challenging with the current staffing shortage. But without the right people, processes and technologies, skilled nursing organizations will struggle with the impending financial challenges. 

Consider external RCM experts

It’s important to remember that external experts are available who can support your internal RCM team as they work to identify issues in your revenue cycle management, improve cash flow and operate more efficiently. Outsourcing RCM services is a proven approach many organizations are adopting to help streamline the revenue cycle and maximize current collections. 

By following these tips, you can help ensure you’re providing the best possible care for your clients and managing your organization’s revenue cycle more efficiently.