The clinical revenue cycle (CRC) is seldom mentioned and under-reported. The more universally recognized concept, of course, is revenue cycle management (RCM). It is the umbrella of which CRC is an integral part and a crucial revenue driver, accounting for a large portion of the direct and indirect cost of providing care. CRC needs to be recognized for this importance, and also requires improvement from its present status with a more holistic approach.
When we hear the word hospital or healthcare our thoughts automatically go to patient care which is not unreasonable. Yet, one must remember that there is also a business side to healthcare. If it is not treated as a business there will not be enough revenue to fund it for survival. Learn more…
The role that the Physician Advisor provides as communicator, facilitator, subject matter expert, and “quarterback” is invaluable. In just performing their intended duties, working with teams and management, managing the silos within Clinical Revenue Cycle can occur.
It seems that there is now a relatively new concept or program that has come into play in healthcare and it is called “Revenue Integrity” (RI). Is it another silo or is it a solution for clinical revenue cycle? According to an HFMA Survey of 125 hospital and health system CFOs and revenue executives, only 44 percent of respondents say their organizations have established revenue integrity programs.
Team empowerment is the essential ingredient to the success of any initiative, but it cannot be engaged without thoughtful processes. Teams are composed of individuals with unique skills, personalities, backgrounds, and drive. Utilizing the ingredients provide here will help provide the cement, the glue, the structure to maintain an holistic approach where the whole is greater than the sum of its parts
Making the Case for Utilization Management 360®. Read how UM360 played a role in a multi-hospital system and will continue to improve Clinical Revenue Cycle Management.
Hospital revenue is declining. What kind of changes does Revenue Cycle Management need to make? What is the solution? The real question to ask is how much pain needs to be endured for RCM to be motivated to change and not just use temporary patches. What will be the precipitating factor that will cause RCM to make some changes now before significant pain. The solution is “Utilization Management 360®”