Cause & Effect in the Revenue Cycle

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Cause & Effect in the Revenue Cycle

Why is patient-due A/R increasing?  What is causing this high denial rate?  How can we improve collection performance?  Don’t you wish you had hard answers to those questions?  Does your revenue cycle sometimes look like an elaborate mystery machine?

I’ve been studying the physician revenue cycle for over 30 years and have learned some powerful Cause –> Effect lessons.  Here are some stand-outs:

 

Lessons learned over 30+ years studying the revenue cycle:

  • Everything is connected to everything – cooperation is vital
  • Downstream impact of small inefficiencies can be magnified
  • Understanding CAUSE & EFFECT is key to optimal performance
  • Root causes are buried deep in the culture
  • Performing robotic operations on claims in the A/R will only take you so far
  • The Human Element has a huge impact on how well the revenue cycle performs
    – it all
    IT ALL COMES DOWN TO QUALITY

    • CAUSE –> EFFECT
    • PEOPLE drive QUALITY, which drives Collection Performance

 Actions/Behaviors leading to negative effects

  • Inaccuracy & Miscommunication
  • Lack of knowledge, standardization, protocols
  • Lack of accountability
  • Uncooperative silos, conflict between teams
  • Disengaged & irate patients

 Values/Actions/Behaviors leading to good effects:

  • Training
  • Accountability
  • Communication & feedback
  • Standardized Work-flows and protocols
  • Cooperation between functions
  • Accuracy & Data Integrity
  • Customer Service & Patient Education

Executing these positive actions/behaviors is extremely challenging and very rewarding. Read more about how Accountability drove a $7M revenue cycle turn-around:        http://medpracticesolutions.com/portfolio/

 

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