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revenue cycle

Using technology and outsourcing to address the revenue cycle labor shortage

Revenue cycle labor shortages are currently one of the most pressing issues across industries. Take any industry – restaurants, hospitals, retail, hospitality, and manufacturing – and you’ll find that this is perhaps the most pressing issue for operations managers.

In healthcare, the labor shortage extends beyond clinical roles and into administrative functions. Front office service, billers, coders, accounts receivable, denial management, and physician credentialing specialists are scarce.

The hospital staffing shortage is exacerbating problems that were already exacerbated by the pandemic. We’ve seen declining reimbursements over the years, necessitating revenue cycle operations to deliver the best financial outcomes, which necessitates deep healthcare and reimbursement process expertise.

Hospitals and healthcare systems are losing employees due to resignations and terminations, despite the fact that expert revenue cycle team members are already in short supply and the mandate to get all employees vaccinated for COVID-19. Many hospitals are on the verge of closing due to a lack of clinical and non-clinical staff; in fact, many rural facilities have already closed. Furthermore, the scarcity has resulted in a talent war, which has resulted in higher salaries and operating costs.

In this blog, we will look at some of the revenue cycle strategies that CFOs are using.

 

IT infrastructure hosted in the cloud

With the requirement to operate remotely, IT leaders are tasked with making mission-critical EHR and RCM platforms available at all times and from any location. Most physician practices are increasing their use of SaaS-based EMR/RCM solutions.

 

Automation of processes

The use of machine learning, AI, and RPA technologies in both clinical and non-clinical revenue cycle solutions is allowing revenue cycle leaders to combat the staffing shortage to some extent. Technology and automation can automate routine, repeatable, labor-intensive tasks and reduce manual labor. For example, claims status automation and portal adoption reduce call center workloads. People can focus on higher-value activities and have higher job satisfaction when they are freed from mundane tasks.

 

Rigor in Operations

While all revenue cycle leaders talk about managing tighter operations, few have invested time and money in implementing workflow systems that allow them to measure, monitor, and manage each employee’s productivity. Improving transactional productivity will result in financial gains in the short term.

 

Outsourcing

Outsourcing, which provides access to trained, certified labor across the country, is perhaps the most popular strategy that organizations are considering. Offshoring credentialing services also provides the advantage of lower cost structures. With the outsourcing and offshoring market nearly two decades old, you can find service providers who have invested in process expertise and technology to assist you in gaining access to best-of-breed practices.

 

Optimizing collection costs necessitates the simultaneous implementation of pervasive change strategies.

Leaders must ask the following questions throughout the revenue cycle operations:

  1. What is it possible to automate?
  2. What technologies should you invest in: workflow automation, analytics, or front-end technology?
  3. Where will you get the funds to invest in cutting-edge technology?
  4. Is this function required to be performed on-site, or can it be outsourced?

While you can address revenue cycle issues in the short term, medical billing services leaders must implement long-term solutions.

 

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Iqra Haseeb

Introduction:

Organised and efficient Team leading Manager, supporting corporate level officers and senior management personnel with demonstrated expertise in financial and operational leadership. Adroit professional exemplifies multi-disciplinary managerial skills in process procedure and policy improvement initiatives. Accomplished in workflow optimization techniques implementation which increases productivity, reduces labour, and maintains business integrity and quality of service.

Skill: 

Extensive Client Coordination., Conducts business analysis to create value, Provide Support in creating or enhancing the business, Develop and manage strategic partnerships to grow business, Provide Insights or Conduct Studies related to Market or Business Operation related problems, Provide assistance in operating and handling the business, Develop and structure concepts, strategies, automating and scaling the business

Expertise:

Developed and implemented favourable pricing structures balancing firm objectives against customer targets., Education Coordinated innovative strategies to accomplish marketing objectives and boost long-term profitability., Reached out to potential customers via telephone, email and in-person inquiries., Worked with existing customers to increase productivity of  services.

Sharjeel Khan

Introduction:

Having 10 years of experience in the Medical Billing Industry & up to date with Government, Commercial, Automobile & Workers Compensation Payer guidelines throughout the U.S.
Strong knowledge of claims procedures and coding, account receivable/collection, Denial Management, Credentialing/EDI Enrollments and Revenue Cycle Management. Experienced in Electronic Claim (5010) Loop and Segment Editing, Creating Paper to Electronic Claims (EDI 837), Resolving EDI Rejections through Practice Management & Clearing house, creating invoices, customized provider reports, Auditing, processing insurance & patient payments, and pursuing past-due balances through unique & proven RCM process and Data Management.

Skill: 

ICD-10-CM, CPT, Coding Guidelines, Diagnosis Coding, Compliance, Facility/Professional Coding, Complete Revenue Cycle Management, Telehealth or Virtual Visits, Provider Education, CMS-1500, Upper hand in almost every top PM/EMR/EHR Software used, and many more...

Specialties:

Behavioral/Mental Health, Neurology, Family/Internal Medicine, Infectious Diseases, Pulmonary & Sleep Medicine, Pain Management, Physical/Sports Medicine and Rehabilitation (Physiatrist), Chiropractic, Podiatry, Radiology, and much more.

The Full-Service Bundle includes;
  1. Medicare for both one practice county and one provider
  2. Medicaid for both one practice location and one provider
  3. BCBS PID for both the practice and one provider
  4. RailRoad Medicare for both one practice county and one provider