The skilled nursing facility revenue cycle is a complex arrangement of many interwoven parts. Typically, healthcare organizations like long-term care and skilled nursing facilities employ multiple systems to manage and care for patients at each step of their journey. This process can become increasingly prone to errors if each system is not properly integrated and staff is not properly trained.
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End-to-end revenue cycle management (RCM) aims to simplify the process and make collections from payers seamless. In this article, we’ll discuss what end-to-end revenue cycle management is and how your long-term care or skilled nursing facility (SNF) can better optimize these processes to be more profitable.
What Is Revenue Cycle Management and Why Is It Important?
End-to-end RCM relieves skilled nursing facility operators from most, if not all, administrative duties so they can focus on resident care and growing their census, rather than managing complex and repetitive billing and collections tasks. By outsourcing their RCM, SNFs can drastically reduce the number of inefficiencies caused by using multiple systems. When RCM processes are fully integrated, fewer errors result in more predictable cash flow and often lead to increased revenue.
Key Benefits of End-to-End Revenue Cycle Management
Skilled nursing operators that outsource their revenue cycle management to a single vendor like LTC Ally experience the benefits of better optimization and daily support from a team of professionals. Our technology and specialists handle all the complexities of revenue cycle management, allowing claim denials to be addressed in real-time, and every billable dollar submitted in the correct manner.
Consolidating Your Back-Office Processes
Paying for multiple services from multiple vendors can quickly add up and introduce risks related to compliance. Skilled nursing facilities also risk mismanaging patient information moving between multiple service providers, which creates billing errors and increases the cost of collections. By consolidating to a single RCM vendor, your facilities can reduce upfront expenses and more securely manage patient data.
Fewer Claim Denials
According to a Medical Group Management Association report, healthcare organizations lost roughly $16.3 billion in 2020 on administrative transactions, most of which could have been avoided through comprehensive end-to-end revenue cycle management. Consolidating to one integrated RCM vendor like LTC Ally reduces data entry errors, in turn reducing the number of claim denials.
What Is the Revenue Cycle Management Process?
Revenue cycle management is the administrative process of managing patient information from pre-intake to post-visit and collecting revenue from each step along the resident journey. The cycle starts when a resident is referred to a facility and ends when the service has been paid in full.
The revenue cycle management process can be broken into seven key steps:
- Scheduling and Preregistration: This step captures resident information before their arrival and ensures that they are properly insured for your facility. When discharge staff refers admissions to your facilities, this information must be collected correctly.
- Registration: Any subsequent information regarding the resident is captured. This step is vital to ensure resident information is correct and to prevent billing issues down the line.
- Charge Capture: A resident is charged when a billable medical service is rendered.
- Claim Submission: Once a medical service has been rendered, the skilled nursing facility will submit claims of billable fees to insurance companies.
- Remittance Processing: Payments are reviewed and are either accepted or rejected once they’ve been received from insurance companies.
- Insurance Follow-Up: Incorrectly processed claims from insurance companies are some of the leading causes of billing issues. SNFs must follow up with third-party insurance providers to ensure proper payments in this crucial step.
- Patient Billing and Collections: Once medical service has been rendered and payments have been received from third parties, it’s time to collect any remaining amount from the resident that the insurance does not cover.
Following these steps will help your skilled nursing facilities avoid costly mistakes. To achieve this, careful management, monitoring, and reporting are necessary.
Partner With RCM Experts
Partnering with accounts receiveable professionals will greatly reduce errors and positively impact your operation. With over 20 years of proven experience, LTC Ally helps nursing homes, assisted living centers, and other operators in long-term care be more competitive—despite tight margins—through our professional, dedicated revenue cycle management services.
For most operators, we can onboard your facilities into our technologically advanced systems in 30 days and begin handling all your RCM needs. Over many years, we have helped LTC operators streamline their processes, and we have found partners who utilize more of our services to achieve even better results. With a full suite of financial management services, you can gain greater insight into your facilities’ daily financial health. With this information, we can leverage creative procedures in our accounts receivable and collections processes to keep that health optimal.