How Should You Staff Your RCM Function?
The healthcare revenue cycle can best be described as a catch-all for every administrative and clinical function that is associated with the collection of patient revenue. Making all of these areas function together as productively and efficiently as possible is called RCM, or revenue cycle management.
For all of the attention paid to RCM in recent years, what is often overlooked is what can make or break its success, and that’s the way in which each distinct RCM function is staffed. It is divided into front-end and back-end areas. Today, we’ll take a closer look at front-end RCM staffing, specifically.
The front end staff of a traditional RCM model manages all patient-facing facets of care and is the literal and figurative face of a practice or hospital system. These areas include four primary areas:
- Patient scheduling
- Patient registration
- Eligibility and authorization
- Patient collections (when immediate or pre-payment for services is required)
Hiring the wrong scheduler can lead to nightmares for both patients and providers. A highly-competent scheduler understands several key variables that another might not. One is the importance of booking patients to minimize their wait times — a common source of frustration. Another is ensuring patients are seen in a timely manner based on their personal health needs. Ultimately, the best schedulers help keep patients coming in and coming back.
Proper staffing of the registration desk is crucial for a number of reasons. It’s often the most outward-facing area of the practice, other than the providers themselves. Staff handling patient registration need to be able to have both excellent customer service skills, as well as competency with the practice’s EHR or other practice management software.
Patient eligibility and insurance authorizations.
This function has both patient- and non-patient facing components, and requires that the individual carrying out the responsibilities have patience, excellent communication skills and a knack for getting the seemingly impossible accomplished. These are the people who must wade through the endless red tape of insurance every single day and have the ability to interface with patients to simplify the complicated, whether it’s billing, claims or denials.
According to a 2015 Availity study, 85% of providers agree that collecting post-visit payments from patients is difficult. This is a trend that is unlikely to reverse itself any time soon, given the increased patient responsibility that has resulted from high-deductible healthcare plans. The same study also stated that most practices only collect around 35% of patient-owed fees up front. Equipping front-office staff with the right tools to make up-front patient collections easier for both patients and personnel can contribute to stronger financial bottom line.
How Via can help.
Between the front-end of RCM that we detailed this week and the back-end functions of RCM (which we’ll discuss next week), there is a slim middle layer. This is the space into which many providers have chosen to integrate Aquina’s Via solution. Via is a tool that expedites insurance claim reimbursements and is invisible to the patient so clinicians can be paid faster, ensuring a healthier practice bottom line. With integration already in place with leading EHR providers such as athenahealth and Kareo, getting started is easy. Contact Aquina Health today and find out how.