Leveraging Technology to Drive Revenue Cycle Results

The revenue cycle challenges facing today's providers, whether broken processes or limited technology, are expansive and lead to lost revenue and less cash.

Typical process challenges include inadequate preregistration activities that lead to reduced cash collected up front, billing errors,

delays in charge entry and coding that result in high discharged not final billed claims, and insufficient data capture that drives denied claims and lost revenue. Frequently, these issues are coupled with overwhelmed collections staff, personnel shortages, and lack of accountability, leading to backlogs in account follow-up, less focus on denials, and the inability to effectively manage underpayments and credit balances. Limited technology, including insufficient tracking, monitoring, and reporting mechanisms for denied accounts and limited-to-no work queue functionality and productivity monitoring, further accentuates these process breakdowns.

A variety of technologies are available to address specific breakdowns in revenue cycle processes or to overcome the shortcomings of existing revenue cycle technology. But in today's capital-constrained healthcare environment, providers often have limited ability to make large investments in cutting-edge, innovative technologies.

How can you make the most of the revenue cycle technology you already have, or make the best IT purchasing decisions for your organization's bottom line? Provider experience points to five key indicators for success.

Keys to Success

Regardless of the type of revenue cycle technology selected--whether it's the replacement of an existing patient accounting system or a bolt-on tool for a temporary and less-expensive fix--providers should focus considerable attention on facilitating implementation, encouraging adoption, and sustaining system use. The following are key indicators of future implementation success.

Process improvement drives IT design decisions, minimizing go-live risk. Providers that develop conceptual and detailed process designs prior to system implementation have a greater likelihood of achieving financial and operational goals with this technology--and are more likely to sustain these benefits. The following should be considered as part of the design process:

* Use enterprise technology investment plans to create the burning platform for revenue cycle change (the "Why now?").