Providers Must Make Revenue Cycle Management a Top Priority

All healthcare providers experience financial constraints that require them to adopt highly efficient practices for managing patient care revenue. Given the extremely tight margins under which substance use and mental health service providers traditionally operate, effective revenue cycle management becomes even more critical for this segment of the healthcare industry.

A Bain and Company report that was based on a June 2023 survey of 201 healthcare executives found that providers consider revenue cycle management to be a major strategic priority in the coming months. These leaders were expecting to commit significant investment to areas of operation such as revenue integrity, charge capture and complex claims as part of their overall healthcare finance strategy.

Behavioral health providers face many challenges as they pursue excellence in revenue cycle management. Payer behavior remains less predictable for mental health and substance use services than for general healthcare. This makes it essential for specialty providers to maximize the efficiency of their data collection and to act decisively on what they learn from the information. Many behavioral health providers also haven’t devoted sufficient resources to staff training on the intracacies of billing and finance.

A formalized revenue cycle management process can take much of the uncertainty out of billing, where denial rates in behavioral health have continued on a steady climb. Effective revenue cycle management requires strong communication and transparency with both the patient served and the payer.

Providers that are strong in this area have systems that support consistent policies in checking patient eligibility for services, monitoring changes to relevant billing codes, and submitting complete claims. All staff members in these roles should be encouraged to collect and record all of the needed data to manage the process, while also reassuring patients and families about how the information is used.

“People are hesitant about giving information,” Bob Stearnes, director of patient accounting at Covenant Health, said in a talk on revenue cycle strategy at the 2023 Healthcare Financial Management Association annual conference, Healthcare Finance News reported. “You have to increase their comfort level to align the resources they need. We have to glean a lot of value from a little bit of information.”

The technology to support these efforts and the leadership to ensure that staff members embrace its use are essential for moving forward. Last year’s Bain and Company survey illustrated the faster pace at which organizations are engaged in healthcare IT spending. Nearly 80% of the surveyed executives reported increases in spending on technology over the past year. A similar percentage said they expected this growth to continue in the coming months. Fifty-six percent of respondents listed software and technology as one of their three most important strategic priorities; only 34% had said the same a year earlier.

In this environment, choosing the right software to guide the revenue cycle management process becomes critical. Given the sensitivity of the patient information that is collected, you and your staff need to have full trust in the experts you choose as partners.

We at Sigmund Software have worked to earn that trust by carefully developing a solution specifically engineered to meet behavioral health providers’ needs. AURA’s finance solutions for behavioral health optimize revenue cycle management, offering the tools that substance use and mental health providers need for robust billing and maximum reimbursement.

With a system such as this in place, your clinical staff will have more time to focus on what it does best: offering the level of patient care and support that positions your organization as a high-quality treatment provider in your community. Let us work with you to understand and strengthen your revenue cycle management process.