Two full months into the year, most organizations have completed their budget process and are executing on strategies to achieve those numbers. Whether that sounds like your organization or an organization you strive to be, it bears repeating: even the best strategies are supported by the basics.
Home Care and intellectual and developmental disabilities (I/DD) providers will continue to be faced with challenges – mandated costs which need to be managed, the EVV™ mandate, value–based care and payments, consumer-directed care, provider and payer consolidation, and increased payer diversity, to name a few. However, if you look at these challenges from a different perspective, they are also all significant opportunities. Having strategic plans in place that focus on these challenges/opportunities, and executing them timely and completely, is more critical than ever.
With thin margins and ever-increasing costs in our businesses, revenue and cash flow are especially critical. Is your revenue cycle performing at its optimum? Are you billing for all services that you provide? Are you getting paid as quickly and completely as you should? If your state is transitioning to managed care and/or EVV, or if you are adding service lines, are you building the revenue cycle processes to get paid? How much of your agency leadership’s time is spent managing this function? Is this the best use of that time?
So, add this to your strategy list: develop an efficient and effective vehicle to focus on the areas of your revenue cycle which could be improved to maximize collections performance.
From an executive vantage point, you can’t determine if your processes are working correctly unless they’re being measured. Just like in medical and automotive diagnostics, having key metrics is crucial. Having the right metrics allows you to leverage your time to maximize efficiency and effectiveness.
There are two approaches you can take:
a) identify an internal or external resource to pull a large list of metrics together, analyze them and create a comprehensive look at your entire revenue cycle, or
b) concentrate on a few metrics, identify and address anything that needs attention, and expand from there.
If you opt for (b), pull together these six to start:
- Revenue vs cash receipts vs cash applied by month for the past 12 months
- Comparative aging trend by bucket for the past 6 months
- Days Sales Outstanding by Payer
- Dollars billed vs collected 120 days after billing
- Unbilled (held) claims
- Unconfirmed/unverified hours (if using electronic visit verification)
Investigating anomalies in these figures will surface opportunities for improvement in your revenue cycle. Make changes, then run the numbers again. Ensure that updated figures are reported to you regularly, so your organization stays on track. Then expand to new metrics.
Sandata Revenue Cycle Management provides revenue cycle outsourcing and support services to Home Care and I/DD agencies, allowing management to focus on providing excellent client care while navigating the opportunities and challenges in our industries. We provide full–service revenue cycle management as well as collections projects. As your partner, we will work with you to maximize your revenue, cash flow, and operational effectiveness.
Schedule a call with our team today and be sure to indicate you are interested in our business services, specifically revenue cycle management.