5 Things You Can Do to Improve the Health of Your Revenue Cycle

Recently we advised you of 5 Things Impacting Your Revenue Cycle Right Now, such as, single payer saturated census, inflated AR and more. Here are 5 things you can do right now to improve the health of your revenue cycle in the behavioral healthcare industry.

1. Acquire, Understand and Assimilate Medical Necessity Criteria and Documentation Standards by Payer – Each payer must provide (in writing) their standards and requirements for service hours, documentation and medical necessity criteria. Knowing what each payer needs will facilitate stronger days, prevent compliance issues and help you avoid unnecessary denials and appeals.
2. Build and Develop an AR Review Process and Team – Monitoring your AR on a weekly basis will keep you in touch with the health of your revenue cycle. This will allow you to avoid costly delays, remove aged claims to keep your AR as accurate as possible and allow you to predict trends in reimbursement and plan financially.
3. Diversify Your Payer Mix – Having a diverse payer mix featuring a healthy blend of payer policies will help to avoid negative financial impact if there is an issue or delay with one of them. Having “all your eggs in one basket” is never a good idea. The payers may slow or halt your revenue for a myriad of different reasons including costly prepayment audits, chart reviews, seasonal processing issues and more.
4. Understand and Comply with Payer Specific Timely Filing Policies and Procedures – Each payer has their own set of rules and regulations governing the appeals and record request processes. Knowing and complying with each of these policies will help avoid unnecessary denials, appeals and write-offs.
5. Hire a Reputable Revenue Cycle Management Company – Managing the health and optimization of a complex revenue cycle can be an extremely challenging task. Hiring a team of experts with a proven track record of excellence in all areas of RCM can often be the difference between success and closing your doors.

For more information on how PRRS, Inc. can help you identify and overcome challenges with your AR, Revenue Cycle and more visit us on the web at www.PRRSInc.com or call 1-888-405-3118 x 238.