Understanding Revenue Cycle Management in Healthcare IT

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Revenue cycle management is the process used by healthcare facilities all over the world to track the revenue from patients — from their initial appointment or encounter with the healthcare system to their final payment of balance. It is a normal part of health administration and can often take months, even years to conclude. Simply stated, healthcare organizations must maintain profitability in order to achieve success, emphasizing the extreme demands for quality revenue cycle management. 

MedSys Group has been in the Healthcare IT space for over 25 years and within that time we have built a solid understanding of the challenges that exist within the clinical delivery and revenue cycle environments. MedSys Group is dedicated to serving as the bridge between these two important areas, supporting organizations to create a healthy, effective connection.

How Revenue Cycle Management Works

The goal of revenue cycle management is to identify any points of friction in the provider’s revenue cycle and resolve them. With proper revenue cycle management, care providers can maximize their claim reimbursements and increase their patient service revenue. An effective revenue cycle management process ensures that the full interaction with a patient from initial inquiry through final payment is effectively managed.

Electronic Health Records (EHRs) can be integrated with other revenue cycle tools and software, such as coding and billing software, claim management software, payment processing software, and analytics and reporting software. Coding errors and denials can be reduced, improving productivity and quality, automating billing processes and workflows, enhancing billing accuracy and compliance, and increasing reimbursement rates and cash flow. 

Through a series of steps strategically detailing the objective and goals to optimize the revenue cycle of your organization, MedSys Group will collaborate in-depth with relevant decision makers at every level. By assessing your current applications within the revenue cycle, MedSys Group will assist you in identifying what’s best for your unique needs.

Phase One: Pre-Implementation

Taking time to understand your organization and your strategic goals, MedSys Group can share our expertise to further define your goals. As your advocate, we will outline the downstream dependencies of each decision you are making so your interests are protected. MedSys Group is a trusted advisor in Healthcare IT positioned to help you with:

  • Implementation Planning and HER Integration   
  • Current State Organization & Key Metrics Assessment
  • Resource Planning and Management   
  • Understanding of Objectives and Goals 
  • Defining Key Performance Indicators

In this phase, MedSys Group will assess all applications used within the revenue cycle and assist with vendor selection based on your needs. We will optimize system integration for efficient data retrieval and provide Legacy AR planning.  With expertise in data extracts and interfacing third party systems, MedSys Group will work with your team throughout the entire journey.

Phase Two: Implementation

Workflows protecting critical operations can be lost in the system configuration discussions during the implementation phase. MedSys Group experts keep your objectives in front of the project team making sure your investment in the project is protected. Without system expertise to drive these conversations, the project costs, scope, and timeline can be impacted. For a seamless conversion process, MedSys Group is fully equipped to assist with:

  • Solution-Based Current State Assessment
  • Engaging Revenue Cycle Integration Early and Often
  • Full Suite Integrations Protecting Assets
  • Quantifiable Project Health Such as Risk Response Planning 

Phase Three: Optimization

Optimization is the phase where you begin to see your metrics surpass any previous goals. The way to fully realize the value of new system changes or upgrades is to partner with a trusted advisor such as MedSys Group to help you structure a strategic optimization plan that aligns with your performance goals. 

  • Current State Analysis to See Opportunities
  • Claims Efficiency Aligned with Corporate Initiatives
  • Benchmark Road-Mapping for Success
  • Continuous Improvement Team Supporting What’s Implemented

Phase Four: Stabilization 

Once a system conversion is complete, there remains a great deal of work to stabilize both clinical and revenue cycle operations. Project resources have been reduced, but many stakeholders continue to need support. MedSys Group will work with all leadership levels to determine where to focus attention based on house-wide assessments and industry standards. With more than 100 large hospital system conversions behind us, we have the keys to get you back to fully functioning operations.

  • Post Conversion Assessments & Benchmarking
  • Maintenance and Self-Sustainment for Confident Navigation
  • Strategic Support Plan to Leverage Full System Capability
  • Clinical Workflows Effect on Revenue Cycle

 

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