Viva la rev cycle revolution!

April 25, 2018
Julie Fogel
Content Marketing Manager,
Hyland Healthcare

The rise in consumerism finds healthcare organizations scrambling to transform their revenue cycle processes in order to create more service-oriented patient experiences. From front-end access and HIM to coding and back-end billing and claims, there’s a call to revolutionize the way revenue cycle professionals interact with patients, from start to finish.

It’s a revolution whose time has come. With the shift from volume to value-based care, healthcare organizations must become more patient-centric—which means the impersonal, transactional nature of the revenue cycle has to end. And, as today’s healthcare consumers are shopping for healthcare in a way they’ve never had to before, patient satisfaction now offers a competitive advantage.

You’ve only got one chance at a first impression

Making a good first impression starts with prescheduling and continues with that first visit.

“Handing me a clipboard with a bunch of forms that have been copied five times, are no longer legible and that ask me for the same information I’ve already provided isn’t a great start. If I can order food in the Houston airport from a tablet, why can’t I use one when I’m sitting in the emergency room with my kid?” said Mike Bernard, Hyland Healthcare manager. “Clipboards are for coaches.”

Courtesy of Hyland Healthcare

The billing experience is the first and the last impression an organization makes, and perhaps the most lasting. A poor billing experience has the ability to negatively impact, if not outright ruin, a patient’s experience. Patients who are satisfied with their billing experience are five times more likely to say they’re satisfied with their overall experience—reaffirming that a patient’s clinical and administrative experiences are merely two sides of the same coin.

Patients are the new payers

Patients now pay approximately one-third of their healthcare costs, compared to just 10% in 2002. Healthcare, as an industry, is at a disadvantage in that there hasn’t been much transparency around cost as it relates to value. We’ve been hesitant to talk about cost, let alone provide estimates for procedures. It’s not without reason. Between the varying amounts of co-insurance and deductibles, even ballpark estimates present risks. For years, consumers have paid a set amount for a service, as determined by their insurer, without really knowing the value of that service, so part of this revenue cycle revolution is education—not only about costs but about the value of those services.

Revenue cycle leaders must begin to make change happen. To do so effectively, they must embrace the consumer’s perspective, asking themselves, “How would I want to be treated?” After all, we are all healthcare consumers, and if the CFO of a large health system can’t understand the bill he receives for his daughter’s treatment, how can we expect the average healthcare consumer to understand it? This revolution is also one of empathy.

Every revolution needs a solid foundation

One significant effort must occur before healthcare organizations can accomplish all of this massive, transformative change to revenue cycle management, however. This revolution must begin with infrastructure.

Before healthcare organizations can empower their employees, they must first offload all of the tasks that don’t require empathy. Save that energy and time for the tasks that do—patient relations, financial counseling, billing collection. Healthcare organizations also have to provide their staff and clinicians with the information they need, and make it easily accessible from within the systems they use every day.

Departmental solutions aren’t the answer. They actually compound the challenge. Just ask any healthcare delivery organization that’s had to navigate a merger or acquisition. Revenue cycle is an enterprise endeavor. It needs an enterprise solution, preferably one that integrates with existing technology to connect disparate systems, increase access to information and provide native business process tools.

Stop leaving money on the table

Existing revenue cycle processes are inefficient and often incorrect. Hospitals submit almost 100% of claims more than once to insurance companies. Insurers must go back to hospitals in order to get the information they need to pay a claim an average of two times.1 One of the biggest frustrations for patients typically occurs after their discharge since 80% to 90% of patient bills are wrong.2 Errors made during registration account for between 30% and 40% of all denials—and only half of those denials ever get resubmitted for payment.3

Not only will providing a proven technology infrastructure allow healthcare organizations to build a solid foundation for truly patient-centric revenue cycle experiences, it will also help with cash flow and reduce the amount of debt healthcare organizations write off each year.

The time is now

Payment models have changed and the consumer landscape has shifted. One needs only to look at the impact the “Amazon experience” has had on purchasing habits and service expectations. Now, you can either blame the millennials who are driving the push for everything to be digital and self-service, or, you can take their lead. Preferably the latter. Not only do millennials have the most purchasing power today, but they’ll be making the majority of healthcare decisions by 2020 and will comprise 75% of the workforce in 2025.

Change is already here.

Viva la revolution!


  2. Medical Billing Advocates of America and CoPatient
  3. TransUnion

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