Three Billing Issues That Could Affect Your Revenue Cycle

Three billing issues that could affect your revenue cycle

 It goes without saying that billing is a critical part of your practice. But did you know that there are several things that you may be doing that are negatively impacting your revenue cycle?

By taking simple steps to improve efficiency, accuracy, and communication, you can make a substantial positive effect on your revenue.

1. Automating claims management

One of the biggest problems is simply a matter of efficiency. Despite all of the technological advances within the healthcare industry, a study released in July by the Healthcare Information and Management Systems Society (HIMSS) Analytics showed that nearly one-third of providers still process claims denials manually.

Not only is this manual work less efficient, it’s also more error prone than an automated system.

“Given the complexities around submitting claims and the labor associated with managing denials, it came as a surprise that more organizations have not automated the denial management process through a vendor-provided solution,” wrote Brendan FitzGerald, HIMSS Analytics director of research, in the survey announcement (

As value-based care rises to become the industry norm, this will become even more important.

The lesson: If you’re still manually processing your denials, investigate an automated or vendor-provided system sooner rather than later.

2. Collecting patient information upfront

Another helpful tactic is to ensure that the intake process for each patient is as thorough as possible. This includes not only demographic information, but insurance information as well. And insurance eligibility should be checked on subsequent visits, not just the initial visit. According to an article published in 2015, just 24 percent of providers check eligibility after a patient’s first visit (

“From a revenue cycle perspective, getting the most accurate information up front starts with patient scheduling and patient registration,” Gary Marlow, vice president of finance for a healthcare system in Massachusetts, told ( “The last thing you want is getting a claim submission kicking back to them then having to work their way through the institution.”

The lesson: Verify your patients’ information on every visit, not just the first one. This is especially true for insurance information.

3. Specifying available payment options

Thanks to a larger number of patients opting for high-deductible healthcare plans, patients now have more responsibility when it comes to paying for services.

During a recent panel discussion held at a revenue cycle conference, conversation turned to the confusion that some consumers are having in deciphering their health insurance coverage and bills. This is especially true for patients who recently acquired insurance through a Affordable Care Act marketplace.

The best way to help reduce this issue — and receive more reliable payment from patients — is to consider alternative payment plans, and to make sure that those plans are easily understood by the consumer. According to panelist Karen Shaffer-Platt of the University of Pittsburgh Medical Center, things like installment plans or loans could go a long way toward not only helping your patients pay, but display good faith in helping to make healthcare more affordable for them.

Yet again, this is extremely important in the evolving environment of value-based care.

“Most patients don’t have the scientific knowledge to differentiate exceptional clinical care, they just know their health improved,” Shaffer-Platt said ( “As consumers, though, patients have a ton of experience in customer service and billing, and that’s where many hospitals fall apart.”

The lesson: Do what you can to help your patients pay their bills by offering multiple payment options and explaining all of them clearly.

COVID-19 Resource Center    Visit our Resource Center to stay up to date.​