When it comes to getting reimbursed, healthcare organizations and medical practices today face significant challenges with getting paid. This includes the rising cost of supplies and services, along with regulatory and compliance costs, rampant physician burnout, and high rates of employee turnover.

Digging deeper, we see that only 38% of physicians believe their organization is on solid financial footing.¹ When surveyed, the most common obstacles that U.S. physicians face today range from difficulty collecting full payment, to administrative burden, regulatory and compliance requirements, and growing industry changes. This data, along with the barriers to getting paid, pose serious threats to the long-term viability and sustainability of many care centers.

But what if there was a way for medical practices to simplify the process of getting paid, so they could increase their collections for services rendered to patients? And what if they could actually decrease overhead at the same time?

Below, we’ll show you how you can update and improve the revenue cycle to help yield higher collection rates and increase efficiency to decrease the administrative burden on staff.

Tips to help optimize your revenue cycle and collect more

1. Improve operational efficiency

By working to streamline the revenue cycle and optimize workflows, your medical practice can help reduce administrative overhead by a significant amount, minimizing errors and redundancies and accelerating cash flow. A few key areas where operational efficiency helps drive healthcare revenue cycle management (RCM) success include front-end processes, such as registration, eligibility verification, and pre-authorization, as well as the medical coding and billing process where efficient medical coding can help minimize errors and delays. Regular audits can help you identify any coding errors or patterns that need to be addressed. Continuous efforts to remove administrative burden, reduce cycle times, and implement lean RCM processes yield significant operational gains, freeing up staff to focus on increasing patient satisfaction by supporting a smooth in-office experience.

2. Digitize bill payments and self-service actions

Focusing on enabling self-serve for patients, as well as incorporating digital bill pay, can enhance the patient experience and help your organization grow over time through patient retention and referrals. What does this look like? It could be things like self-scheduling appointments, paying bills through a portal online, messaging doctors conveniently, or all of the above. Providing self-service actions for patients helps provide them with flexibility around care and payment options and helps your medical practice maintain schedule density without staff support. Digital bill pay may also help remove barriers to payment, so patients can make digital payments quickly and on their own time.

3. Gain visibility into financial performance metrics

How can you improve financial performance if you’re unaware of how your organization stacks up against competitors? You need benchmark data to help your medical practice grow and make improvements year over year. Certain RCM solutions can help you use metrics to enhance your perspective on the market by leveraging healthcare industry insights and benchmark data of other care centers similar to your own. This helps you understand what your peers are doing, what payers will require, and how to stay on top of it all. A healthcare RCM solution that includes a financial performance dashboard is an easy way to proactively address revenue challenges before they arise and can help your business identify new areas of potential growth.

4. Use a cloud-based RCM tool

A cloud-based healthcare RCM tool can actually help healthcare organizations and medical practices save money on maintenance, energy, and operational costs compared to an on-prem tool. Using a cloud-based solution can give you access to real-time updates and data related to medical billing rules, medical coding, and more, with support software services that can help reduce burden and create cleaner medical claims. Managing your medical practice’s revenue cycle in the cloud can also provide better data security and reliability through encryption and regular backups and monitoring. What’s more, as your organization grows, you can scale cloud storage easily to accommodate new data.

With these tips and tricks, you can begin to implement sustainable improvements and changes into the healthcare revenue cycle, helping you position your organization for future expansion and increased revenue. So, how is athenahealth helping medical practices to do exactly this? Let’s take a closer look.

How athenahealth’s RCM solution helps customers to collect more and increase efficiency

For over 25 years, athenahealth has been helping medical practices to simplify the revenue cycle from appointment scheduling and patient registry, all the way to claims resolution and securing full payment. We help your organization to streamline revenue cycle management and optimize for efficiency, so you can get paid what’s owed. Using athenahealth’s revenue cycle services, medical practices can drive financial performance across fee-for-service, value-based care, and hybrid payment models, proactively navigating regulatory changes to help reduce administrative burden.

Data from the healthcare consulting firm, Coker Group, shows just how much athenahealth can help organizations improve financial performance.

This data shows how the power of athenaOne can help medical practices like yours to take revenue cycle and financial performance to the next level. After all, business growth is about integrating durable changes and process improvements that compound over time to produce success. So, let’s look at a few examples of how we help your organization succeed.

Here are just some of the ways that athenahealth helps your medical practice optimize financial performance:

1. Efficient scheduling for a robust patient roster

We start at the very beginning of the patient's journey with intuitive scheduling solutions that integrate seamlessly with the rest of the practice's operations, ensuring smooth patient flow and optimized appointment management.

2. Advanced medical billing rules engine to resolve claims quickly

Our extensive medical billing rules engine is at the heart of our RCM offering. Over 30,000 rules in our billing rules engine help catch possible errors before claim submission,² minimizing denials and supporting a more efficient and precise payment process.

3. Claims creation and management for more efficient claims processing

With our sophisticated claims creation and management tools, we take the complexity out of this critical step. Our platform helps ensure that claims are processed efficiently and accurately, improving turnaround times and cash flow.

4. Denials management to proactively identify claims issues

Our approach to denials management helps identify potential issues before they result in denied claims. When denials do occur, our comprehensive review process makes resolution swift and straightforward, minimizing delays in payment.

5. Self-pay billing for easier patient payments

Our digital self-pay billing solutions are designed to make submitting payments as straightforward and simple as possible for both patients and practices, helping to increase satisfaction and improve collection rates. In fact, practices that use athenahealth’s online payment solutions have a 44% higher patient pay yield than practices that don’t.³

6. Real-time connectivity for comprehensive clinical insights

Our healthcare RCM tool has real-time connectivity with our Clinicals and Patient Engagement platforms. This integration provides practices with unparalleled insights across the entire patient care spectrum—from scheduling and billing to patient engagement and clinical outcomes.

In order to navigate challenges to reimbursement and payment, your care center should work to reduce complexity throughout the revenue cycle process. Using the athenaOne all-in-one solution, your healthcare organization can see increased collections while also reducing overhead, helping your business get what’s owed quickly and efficiently. By taking action today, your organization can help ensure you’re optimizing collections and setting yourself up for future growth.

Interested in learning more? Try these related topics:

How healthcare organizations can optimize financial performance and increase revenue

Leveraging HIT solutions so your healthcare organization can achieve growth

Key ways your healthcare organization can use technology to simplify value-based care

*Coker Group is an independent consulting practice that periodically provides onboarding services on behalf of athenahealth and athenaOne clients. Commentary reflects the real-life experience and opinions of Coker Group, may not be representative of all athenaOne clients, and is not intended to represent or guarantee similar results.

1. 2023 Physician Sentiment Survey, commissioned by athenahealth and fielded by Harris Poll, Jan 2024
2. Based on athenahealth data as of Apr. 2023; M017
3. Based on athenahealth data as of Dec. 2023. Patient Pay Yield (PPY) is the percentage of patient balance collected within 6 months of the date of service; M046