EHRs are the front end of Revenue Cycle Management (RCM)

As an independent physician, you begin your revenue cycle the moment a patient calls in for an appointment. The front end of the revenue cycle involves scheduling, registration, eligibility verification, and upfront payment collections. Your electronic health record (EHR) solution is the key to your revenue cycle management (RCM) front end.

The entire revenue cycle is the progression of events that:

  • Starts when the patient makes the appointment
  • Continues when the patient pays for the visit, including a copay or deductible
  • Is completed when you are reimbursed by any third-party payers for the care delivery.

The efficiency of your practice will drive your financial success. Scheduling that minimizes patient wait times and that ensures patients come in at the appropriate time for their needs is critical. Long wait times and limited care access can put the viability of your practice, as well as the quality of healthcare your patients receive, in jeopardy.

EHRs are the front end of RCM once your patient is registered in your database. Messages, emails, and letters can then be sent directly from your EHR. Phone calls are also important for reminding patients of upcoming appointments and any instructions they need to adhere to for their appointment to be successful. To ensure your no-show rates remain low, which can also affect your revenue cycle, schedulers should use multiple communication methods for reaching out to patients.

When your patient arrives for the appointment, your front office staff continue to be an essential part of ensuring your revenue cycle is properly managed from the beginning. The front office experience in the EHR is the first step. Gathering accurate information is crucial to helping revenue flow seamlessly throughout the revenue cycle.

Many activities on the front end of RCM can complicate its full completion, including:

  • Coding complexity
  • Miscommunication
  • Medical billing errors

Optimizing the use of your EHR at the front end of the revenue cycle can help reduce or eliminate these complications. Your front office staff can verify patient eligibility and visit authorization on each visit. Checking this information every time will help ensure that the billing aspect of the cycle is error-free and that you will be reimbursed for the care you provided.

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When your staff collects information at the right time, before you provide healthcare services to the patient, the more efficiently and effectively your practice will function throughout the RCM. In addition, maintaining a detailed patient record will help you understand in detail the various health issues and concerns your patient has from the beginning of the revenue cycle.

Your EHR system is the key for you to be able to streamline your healthcare revenue cycle management strategies, ensuring that the process is accurate and will result in appropriate payment. This technology will enable you to facilitate a steady stream of revenue by:

  • Tracking claims throughout their lifecycles
  • Collecting payments
  • Addressing claim denials.

Patient payments, reimbursement, and patient communication are all streamlined through the EHR. You can use your system to synchronize these facets of the revenue cycle, so you can continue to focus on delivering high quality healthcare while maintaining financial viability for your practice.