As the year comes to a close, you’re likely taking stock of where to focus your revenue cycle efforts to collect more revenue and sustain growth once we turn the page on 2024. Regardless of whether you operate a small practice or a large provider health system, you have an ongoing goal to bill more efficiently and achieve financial transparency. Preparing your healthcare organization’s revenue cycle for success in 2025 is crucial for staying competitive and providing excellent patient care.

We’ve identified six essential steps to take as you develop your roadmap for the new year.

STEP 1: Embrace EHR software integration. In the absence of effective EHR software integration, you may be experiencing inefficiencies that complicate billing processes and data collection. Reflect on how well your EHR performed over the past 12 months and if it’s meeting your standards for customizability, user-friendliness, and compliance. If integrated properly from the outset and evaluated on a routine basis, your EHR software can serve as a workhorse for your RCM efforts year-to-year.

STEP 2: Optimize coding and documentation. It’s critical to identify and correct coding issues early in the billing cycle to avoid claim denials and revenue leaks. For example, a simple typographical error from a physician may result in an incorrect procedure code, leading to a denied claim. Consider doing a coding audit of the past year to identify any discrepancies and room for improvement. Ensure your staff is well-trained in the latest coding practices and documentation standards and identify communication improvements to adopt between teams to iron out common errors.

STEP 3: Focus on claim denial management. Did your practice experience a large volume of claim denials over the past year? Common denial causes include eligibility verification errors, coding inaccuracies, and issues in the claims submission process. Med USA can work with you to determine why you may be experiencing an uptick in denials and develop a plan for getting ahead of errors and issues going forward. If needed, Med USA can provide a dedicated team to resolve denials and shorten AR days, reducing the workload on in-house billing teams.

STEP 4: Implement data analytics. Utilize data analytics to monitor key performance indicators (KPIs) such as days in accounts receivable (AR), denial rate, and net collection rate, and identify trends or areas for improvement. For example, a lower number of days in AR typically signifies a more efficient revenue cycle, while a higher number may indicate potential issues in the billing and collections process and point to a need for further assessment. However, to best set you up for success, the right business intelligence tool should be adapted to your practice’s unique needs. Paired with effective RCM solutions, these tools can streamline processes while simultaneously providing the data insights needed for ongoing improvement.

STEP 5: Enhance patient engagement. According to a recent survey, 48% of revenue cycle leaders have identified timely patient collections as their top concern for 2024.¹ Engaged patients stay current with their health and financial responsibilities, leading to better outcomes. Focusing on improving patient communication and engagement is crucial. By providing clear information about costs, payment options, and financial assistance and utilizing patient portals to facilitate online payments and access to billing information, you can enhance patient billing transparency and communication and strengthen the bond with your patients, making them feel more cared for and connected.

STEP 6: Stay informed on regulatory changes. Knowledge is power, and by keeping abreast of changes in healthcare regulations, reimbursement policies, and payer requirements, you can minimize potential liability and empower your team with best practices. A strong focus on maintaining compliance also gives the practice a sense of security; as you continually integrate new technology and improvements to keep up with the changing healthcare environment, it’s reassuring to know you’re keeping up with regulations.

Transform Your Practice’s Revenue Cycle for a Successful 2025 with Med USA

Med USA’s end-to-end service is your gateway to maximum accuracy, efficiency, and revenue. Our unique tools allow you to streamline your operations and boost your financial performance. Paired with our enterprise healthcare RCM solutions, Med USA’s clients are well-positioned for long-term bottom-line growth.

Want to See Our Business Intelligence Tool In Action?

Schedule a demo with a Med USA representative today!

Sources:

1. (2024). “Trends in Healthcare Payments” annual report. JP Morgan. https://www.jpmorgan.com/insights/payments/payment-trends/healthcare-payment-trends