The behavioral health business is not about dealing with patients and providing their needed care. It requires a lot of expertise and strategies to maintain the revenue flow and sustain growth. Such can be encompassed with efficient revenue cycle solutions by experts in the behavioral health field that boost revenue with effective financial strategies and program management.
Financial advisors from Strategieque Partners have key expertise in managing all your revenue cycles and facilities. Consult to learn more!
Behavioral Health Revenue Cycle Management: Key Insights
Healthcare revenue cycle management (RCM) in the United States is expected to grow to multimillion by 2029. It involves managing your facility’s financial chores involving administrative roles via a set of medical billing systems to ensure transparency, collect revenue, and organize finances. In behavioral health, RCM accompanies the same except for a few additional processes.
7 Solutions That Experts Apply to Improve RCM
You have gained insight into why RCM is necessary to improve your behavioral health revenue. Let’s talk about how RCM can be efficiently managed to improve revenue generation and growth outcomes by following 7 expert-advised steps.
1. Create Attractive Payment Policies
Getting ahead in billing and payment policies of behavioral health revenue cycle sustaining is crucial to avoid any potential cash flow disruption. Simplify your payment policy by describing the following:
- Types of payments and insurance you accept
- Consequences and treatment hampering nonpayments
- The time frame of patients’ payment through pocket payments
This will ease the process of understanding and arranging payments for both the client and your management team.
2. Check Your Client’s Benefits
After the appointment, the next step is to check eligibility and verify your patient’s eligibility to ensure which category of benefits is being allowed by their insurance provider. This will help in
- Providing transparency
- Calculating the out-of-pocket payments
- Insurance coverage and active verification
Establishing communication with payers and automating the verification process can streamline these solutions via expert turn-key solution programs for RCM.
3. Accurate and Comprehensive Charge Capture
Along with all other essentials, timely and accurate payment collection is crucial for RCM’s success. This can be done byÂ
- Integrating efficient collection policies
- Automating self-pay collections
- Administering active payment plans
Effective financial policies and expert financial solutions can minimize claim denial. As billing codes and regulations are dynamic, it is best to keep a consultant ready to be aware of market changes and claim comprehensive charge capture.
4. Protective Approach to Billing
Most people are scared of billing their clients when it comes to treatment. They often avoid this due to the high cost and hidden charges. Protecting yourself and your client in terms of financial outcomes is necessary to obtain the desired outcomes when managing revenue. A recent study revealed affordability to be the greatest barrier to healthcare, and accurate billing options with minimal cost engagement on self-pay, error-free payments, and correct cost analysis can avoid it.
5. Develop Healthcare Analytics and Reporting
As the billing operations are complete, a system of analytics and reporting should improve the revenue management system for behavioral health businesses. Make electronic health records (EHR) a mandatory part of your facility. This helps to report the payments received and resubmit denied claims.
Analytics, on the other hand, can help to track data and record claims of success of your business from time to time. This approach will let you analyze your flaws and work on pain points hindering the outcome of efficient revenue collection.
6. Avoiding Reasons for Denial Claims
Even with perfect revenue management solutions for behavioral health, you might not be able to claim your share due to:
- Lack of provider credentials
- Claims were not managed properly by the filing staff
- No specification of billing terms
All these conditions hamper the RCM but can be covered when you plan well by coordinated program management.
7. Appropriate Staffing to Overcome Burden
As demand surges, behavioral health staffing is severely understaffed. When a facility is short of staff, it cannot manage the burden of revenue management, which negatively affects the business. Efficient staffing is the key to success in streamlining all processes.
Benefits of Outsource Your RCM Services
When you and your team are busy managing the clinical chores and providing extensive care to clients, you will understand how outsourcing can tremendously increase your business efficiency.
- Hassle-free claim submission, verification, and authorization
- Payment posting and reconciliation
- Improves key performance indicators (KPI)
- Reduces the lag time between service and billing
- Financial dashboard integration to track records of denials and revenue generated
- Automatic analysis of services, rates, and charges, whether claimable or not
This also improves operational efficiency and makes reporting and analytics better for the owners to keep a track record of every move! We Strategique Partners can help you achieve all of it in one go with our:
- Program Development and Management Services
- Operational and Financial Services
- Data tracking and Outcome Management
- Billing services
So, Consult today to multiply and streamline your revenue!
Common Questions about Behavioral Health Revenue Cycle Management
Some common queries often asked about RCM in behavioral health include:
What Is the Revenue Cycle of Claims?
It involves coding, processing claims, and collecting repayment from the insurer and the patient after the revenue cycle is completed via registration, eligibility check, charge capture, claim submission, etc.
What Is the Revenue Cycle From the Patient’s Perspective?
The revenue cycle for patients starts when they register and make an appointment with a treatment provider. The cycle is completed when both the patient and their insurer have paid off the financial responsibilities to the provider.
What Are the Six Stages of the Revenue Cycle?
The revenue cycle for any behavioral healthcare or healthcare industry includes the following:
- Patient pre-arrival
- Arrival
- Charge capture and entry
- Claim submission
- Remittance processing
- CollectionÂ
After it is completed, the patients are free to walk away from the treatment facility while completing the treatment process.
What Does EOB Mean?
EOB stands for Explanation of Benefits, which is a statement that shows your total charges for your visit. It explains how much your insurance provider will pay out of the total expenses incurred in your whole treatment when they provide you with a detailed note.
What Does Coinsurance Mean?
Coinsurance is a term used by insurance providers. It is the amount that a patient has to pay out of their pocket after they have met the deductibles from their insurance plan.
Related Resources:
From Author
In the complex world of behavioral health, the revenue cycle is more than just numbers on a balance sheet—it’s the lifeline that ensures we can continue to make a real difference in people’s lives. From my journey in this field, I’ve learned that the key to thriving isn’t just about managing costs and increasing profits; it’s about creating a system that supports both the financial sustainability of our practice and the well-being of those we serve. Success here demands more than just technical know-how; it requires a commitment to innovation, regulatory compliance, and a deep empathy for our patients. By refining these processes, we secure our business’s future and amplify our ability to deliver compassionate care. Let’s dive into how we can transform the revenue cycle into a powerful tool for both financial stability and impactful care.
