Your practice’s financial health is determined before a patient ever steps into the exam room. Front-end revenue cycle management sets the stage for smooth claims, timely payments, and a thriving practice. Yet it’s often overlooked, which can lead to costly denials and delayed revenue.
Front-end rejection in medical billing accounts for roughly half of denials, which means it deserves just as much attention as the back end of your billing and claims submission processes. Discover the best strategies for optimizing front-end revenue cycle management.
The front-end revenue cycle encompasses registration, insurance verification, and upfront payment collection. Getting it right reduces denials and boosts your cash flow. It also gives your team more time to focus on patient care.
Here’s why each stage of the cycle is important.
During registration, your team has the first and best opportunity to collect accurate patient data, such as demographics and insurance details. Even a minor error here can lead to rejections and rework.
This is also a chance to make a good impression on new patients. Focus on refining your onboarding processes to create a smooth, integrated experience.
Now is your chance to confirm that the patient’s insurance policy covers the procedure or treatment they are scheduled for. Thoroughness during this stage promotes compliance with the No Surprises Act and boosts your reputation — surprise medical bills are the surest way to end up with a dissatisfied patient.
Confirming proper coverage before services ensures that claims are valid. On the other hand, cutting corners here increases the risk of denials and lost revenue. Use your payer contracts and knowledge of denial trends to verify coverage and bill insurers and patients accurately.
Unfortunately, offices that have unreliable eligibility and benefits verification processes tend to struggle with accurate upfront billing. As a result, they collect only part (or none) of the payment before rendering services and have to try to chase down revenue later.
Collecting payments early improves cash flow and reduces friction in the patient journey. Without clear estimates, you’re left backtracking.
Want to learn more about the benefits of upfront collection and how to get it right? Download our ebook Accelerate Cash Flow Through Upfront Collection.
Even well-meaning practices can stumble in front-end revenue cycle management. Here are the top pitfalls and their consequences.
No matter which patient or staff member is involved in a transaction, the procedure should be the same. Inconsistent registration or verification processes lead to errors, which create downstream claim rejections and payment delays.
For example, collecting patient deductibles up front must be standard. Create and enforce a policy where your team members collect payment before services are rendered. This simple change can have a huge impact on your revenue and cash flow.
Team members who aren’t trained to capture complete, accurate data introduce mistakes that ripple through the revenue cycle. Ensure your employees know why accurate data collection matters and give them tools to gather patient information with lightning-fast efficiency.
For example, a patient management system that automatically flags accounts with typos or missing information will help your staff be more thorough when entering data. In turn, you can cut down on rework and improve your clean claim rate.
Relying on spreadsheets or manual processes slows your team down. This old-school approach also increases errors and drives up administrative costs. Your team will waste time tracking down shared files, and they could also end up working from outdated information.
These mistakes aren’t just inconveniences; they directly impact your bottom line. The good news is that you can turn things around, and it starts with front-end revenue cycle management.
Optimizing the start of your revenue cycle doesn’t have to be intimidating. Here’s how to increase upfront collections and improve front-end RCM processes.
Start with the point of data collection. Use digital tools to capture accurate patient information so you can start every new relationship off with up-to-date and complete data. Automated forms and real-time data checks reduce errors and save your team time.
Not sure where to begin? Talk to your registration staff. They can provide actionable insights and identify bottlenecks that make the process less efficient.
Implement automated eligibility and benefits checks to confirm that a procedure is covered before you provide services. Reworking your verification process reduces patient friction. It also helps you catch issues early and prevent denials.
Improving your verification process is more important than ever, thanks to the No Surprises Act. You are obligated to provide your patients with accurate upfront estimates. A modern benefits verification process makes pricing transparency possible.
Provide accurate cost estimates and collect payments before services are rendered. Create clear policies and train your team on the importance of upfront collections. Finally, communicate with patients so they understand their out-of-pocket costs and aren’t caught off guard by a surprise bill weeks or months after their visit.
Rivet Health’s Patient Pricing and Denial Prevention solutions empower you to master front-end revenue cycle management. Here’s how:
Our tools help you identify where you are losing revenue and fix the issues at their source. Want to enhance every stage of your revenue cycle? Learn more about Rivet’s denial management software.
Revenue success begins with the front end of your RCM. Rivet Health’s solutions help you stop the bleeding and capture more revenue.
If you’re ready to transform your revenue cycle, schedule a demo with Rivet Health!
