a quarterly report by - Technopak

perspective
a quar terly repor t by
Volume 02 / 2009
| Volume 02
While managing a hospital revenue cycle, the following ought to be kept in mind:
•Payment
collection: Hospitals can optimize revenues by putting in place a defined process for collecting
payments from patients either at registration or at day end
•Third-party
payers: Absence of standard protocols leads to ambiguity which causes complexity in the
matter and delays
•Follow-up:
Hospitals need to have an agile follow- up system to ensure timely payments
•Denial
management: This involves sorting out circumstances which led to claim denial. They can vary
from failure on part of patient to adhere to standard procedures or clinician confusion with respect to
treatment
•Healthcare
is witnessing a transition from Out-of-pocket spending towards Corporate and Third-party
Payments. As a result, Hospital Revenue Cycle Management will become a critical factor in determining
the financial health of the providers
•Outstanding revenues that exceed
the industry average
•Receivables inexcess of 30%
of revenue
•Increase in bad debts as % of
revenue
•Lack of Working Capital
47 | Building Operational Efficiency in Healthcare Delivery
Average collection period = (Net amount receivable * 365) ÷ Net patient revenues
(Measured as days in net accounts receivable)
A shorter average collection period implies that the hospital receives faster payments from the insurer)
Exhibit 9 Exhibit 10
What to look out for: Some of the Best Practices
Registration
•Collection of all neccesary
demographic data for
scheduled patients
•Defined prerequisites
•On-line alert indicators
•Regular tracking and
monitoring
Payment collections Denial Management
•Standardized policies,
procedures and employee
training
•Optimal utilization of IT
•Electronic claimssubmission
•Denial tracking
•Case reviews
•Documentation of all
interactions