Behavioral health organizations of all sizes recognize the need to humanize revenue cycle management (RCM) — not just as a means to improve the bottom line but as a vital component of patient empowerment. When patients are treated with empathy and respect in financial matters, they place more trust in the healthcare provider and are encouraged to take charge of their financial obligations without feeling overwhelmed or ashamed.
Most often, patients are grateful for their care and genuinely want to meet their financial responsibility. However, barriers like changes in coverage, complicated or surprise medical bills, and other factors impede this willingness. Sometimes, the guilt and anxiety associated with falling behind on payments can dissuade patients from seeking necessary care when they need it. This avoidance may lead to a sicker patient population and escalating healthcare costs — a lose-lose circumstance for patients and healthcare providers.
Here, we discuss how personalizing and humanizing revenue cycle management best practices can increase patient engagement and help behavioral health and human services (BHHS) organizations achieve better financial stability.
The Complex Reality of Patient Financial Experience
The patient's financial experience in health care is not just a matter of numbers and transactions; it's an intricate and often distressing journey. A recent national survey underscores the profound challenges patients face:
- About 40% of adults delay seeking necessary medical care due to financial constraints.
- 1 in 7 adults with healthcare debt say they have been denied care by a medical practice because their bills are unpaid.
- The American Cancer Society reports that 32% report more depression and anxiety as a direct result of owing money to healthcare practices. Moreover, 45% feel a sense of hopelessness regarding their medical debt, fearing they may never escape it.
These statistics depict a troubling reality. Financial distress in health care goes beyond the inability to pay — it's a significant contributor to the deterioration of mental health and well-being. Patients are not just avoiding or delaying treatment due to cost but are also experiencing profound psychological impacts as a result of financial burdens. This cycle of financial strain and health avoidance creates a domino effect, leading to worse health outcomes and, ironically, potentially higher costs in the long run.
11 Revenue Cycle Management Best Practices to Enhance the Patient Financial Experience
Today, a streamlined and efficient billing process is a financial imperative. It’s also a cornerstone for enhancing patient care and ensuring smooth organizational workflows. You can utilize the revenue cycle management best practices presented here to navigate these unique challenges, ultimately improving the patient experience and organizational profitability.
1. Start Early With Data Accuracy and Claim Denial Management
Consider this as an early lifecycle approach to improving the patient experience. Accurate data collection at the outset — during registration and insurance verification — is critical. Verifying patient insurance eligibility alone significantly reduces the risk of denied claims and payment delays, which are prevalent in behavioral health billing. Timely and accurate data entry ensures a smoother billing process and reduced administrative burden.
2. Ensure Transparent Billing and Financial Communication
Clear billing practices forge patient trust and diminish billing disputes. Providing upfront information about treatment costs, insurance coverage, reimbursements, patient responsibility (copayments and deductibles), and payment policies reduces patient anxiety and bolsters the likelihood of timely payments. Early conversations about costs can influence patient satisfaction and retention, impacting an organization's revenue positively.
3. Prioritize Patient Financial Engagement
Patient engagement in the financial aspect of their healthcare journey is essential. Using various communication channels like phone, email, and text messaging from the very beginning will ease patients into the process, fostering a sense of empowerment and involvement. Keeping patients informed about their billing status through automated messages can enhance their experience without overburdening staff.
4. Offer Patient-Friendly Payment Solutions
Adopting a patient-centered approach in billing translates to flexible payment options that cater to individual patient needs. The use of technology in facilitating convenient payment methods not only improves the patient experience but also streamlines the payment process.
5. Provide Digital Pre-Registration and Self-Service Options
Investing in technology for automating early-stage tasks, such as pre-registration and eligibility verification, is crucial. Streamlining these processes enhances the patient experience and improves the efficiency of the revenue cycle by reducing administrative load.
6. Personalize Financial Counseling
Providing individualized counseling helps patients navigate their healthcare finances and improves collection rates. Effective front-end RCM processes ensure clear financial expectations and obligations, which are important for maintaining financial stability.
7. Establish Proactive Insurance Assistance
Assisting patients with insurance verification and pre-authorization from payers will reduce denials and payment delays, thereby enhancing revenue flow. This proactive approach should significantly streamline the billing process.
8. Tap Into Data-Driven Patient Engagement Strategies
Using advanced data analytics to predict patient behavior means you can tailor communication and engagement strategies to improve patient adherence to treatment plans and financial obligations. It benefits the organization's overall financial health and patient outcomes.
9. Use Feedback Mechanisms for Continuous Improvement
Implementing surveys is perfect for gathering insight into financial and administrative aspects. It enables continuous refinement of RCM strategies and enhances patient satisfaction.
10. Integrate Care Coordination
Leveraging technology like electronic health records and automated verification systems streamlines front-end processes, reduces manual errors, and improves the patient experience. This integration ensures seamless coordination between clinical and administrative aspects of care.
11. Humanize Collections Notifications and Payment Reminders
When you provide clear and concise communication about the financial aspects of care, it may reduce patient stress. Business process automation (insurance updates and payment reminders) is key in informing patients about their account status.
Alongside that, it’s important to prioritize compelling and empathetic email subject lines and text messaging that respects the patient’s financial situation.
Sample email subject lines:
- Your Health, Your Plan: Let's Talk About Your Next Steps
- We're Here for You: Understanding Your Billing Statement
- Update on Your Account – Options Available for You
- Together in Your Healthcare Journey: Payment Solutions
- Your Wellness Matters: Flexible Payment Opportunities
- Empowering Your Healthcare Decisions: Let’s Explore Your Options
- A Friendly Reminder: Your Next Step in Healthcare Financing
- Building a Healthier Future: Your Payment Plan Awaits
Sample SMS text alerts:
- Hi [Patient Name], just a reminder about your account balance. We’re here to help if you need assistance or options.
- [Clinic Name] here: Your latest billing statement is ready. Let us know if you need a flexible plan or have any questions.
- Need clarity on your bill? Reply to this message, and we’ll guide you through it. Your health is our priority.
- A friendly reminder from [Clinic Name]: Your payment is due soon. We're here to support you with flexible options.
- Update from [Clinic Name]: Your account has a new statement. Let’s find a plan that works for you!
Measuring Success: Key Performance Indicators KPIs and Metrics
Once you have revenue cycle management best practices in place, the following metrics and benchmarks go beyond cash flow to provide insights into various aspects of billing and payment processes, patient engagement, and overall financial health to ensure the best claims management.
Claim denial rate: Measures the percentage of claims denied by patients’ insurance companies. A lower rate indicates more effective billing processes and accurate claim processing.
Days in accounts receivable (A/R): Tracks the average number of days it takes to collect payments. Shorter A/R days suggest efficient billing and collection processes.
Patient satisfaction scores: Assesses patient feedback regarding their financial interactions. High scores indicate successful patient communication and financial management strategies.
Cost to collect: Calculates the cost incurred to collect payments. Lower costs indicate more efficient and streamlined RCM operations.
Percentage of clean claims: Evaluates the proportion of claims accepted and paid on the first submission. Higher percentages point to accurate and efficient billing practices.
Patient financial responsibility rate: Measures the amount patients pay out-of-pocket. Monitoring changes in this rate helps explain patient payment behaviors and the effectiveness of financial communication strategies.
Collection rate: Determines the percentage of billed charges that are successfully collected. A higher collection rate indicates more effective billing and follow-up processes.
Average revenue per patient: Calculates the average income generated per patient. This KPI helps to assess the overall financial health and profitability of an organization.
First pass resolution rate: Measures the rate at which insurance claims are resolved without rework or resubmission. Higher rates indicate better initial claim accuracy and efficiency.
Benefits of Working With a Behavioral Health Partner
The revenue cycle management software built into ContinuumCloud's comprehensive electronic health record system is the perfect starting point for implementing and optimizing all aspects of practice management. BHHS organizations benefit from this cloud-based software, which streamlines and enhances all aspects of the revenue cycle.
ContinuumCloud’s RCM software excels in facilitating accurate and efficient claim submissions. With features that enable clean claim submissions and reduce denial rates, organizations should expect a smoother billing process and quicker reimbursements. This is crucial in managing the financial health of behavioral health organizations, where billing complexities are often heightened.
By offering clear, detailed explanations of patient obligations and incorporating flexible payment options, ContinuumCloud’s EHR solution can help you mitigate patient anxiety regarding financial responsibilities. This approach improves patient satisfaction while encouraging timely payments.
The platform's robust data analytics and reporting capabilities enable organizations to closely monitor key performance indicators (KPIs), providing insights into claim denial rates, days in accounts receivable, and patient payment behaviors. This data-driven approach assists in making informed decisions to refine RCM strategies continually.
Beyond this, the CaredFor app is a mobile-based patient engagement platform that enhances the patient financial experience by keeping the communication lines open.
It’s Time to Implement Patient-Forward Revenue Cycle Management Best Practices
Putting patients at the center of revenue cycle management is key to positively framing the payment process. For mid-size and large behavioral health organizations with multiple facilities, implementing empathetic and transparent revenue cycle management best practices becomes even more essential. BHHS organizations are pivotal in transforming this daunting financial experience into a more manageable, understandable, and respectful journey.
By adopting best practices in RCM, your organization can improve its financial performance and contribute significantly to the mental and physical well-being of your patients. It helps to have a technology partner, and we are here to help.