Improving healthcare delivery through human revenue cycle management

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Never has it been more important for private practices, healthcare networks and hospitals to focus on maximizing revenue while maintaining patient care quality.

Staffing shortages and high turnover rates, due to a tight labor market, and increased administrative burdens, due to new regulations and technologies, are hampering the medical industry and impeding workflow.

Hundreds of EHR software platforms are now on the market for managing medical records, referrals, and insurance coverage. This technology is supposed to increase efficiency and improve the revenue cycle by providing applications for more accurate coding and reimbursement, yet the reality is mixed for many healthcare providers (HCPs).

HCPs now face an abundance of frustrations:

• Transitioning to a new EHR system requires increasingly greater technological proficiency.
• Complicated data transfers may lose important patient information.
• Entering EHR data during an appointment takes time and reduces patient focus, which can compromise care and lead to patient dissatisfaction.
• Closing charts after hours contributes to provider burnout.
• Charting backlogs delay reimbursement and impede the revenue cycle.

Human resource challenges also hamstring front and back-office efficiency, with administrative issues predicted to worsen. According to U.S. Bureau of Labor Statistics (BLS) projections, U.S. healthcare job openings in the U.S. are projected to grow nearly 28% between 2021 and 2031. This will be driven in partby a massive, aging Baby Boomer generation, who will require more healthcare services.

As the human side of revenue cycle management becomes more of a growing concern, medical practices, hospitals, and health systems are seeking alternative solutions, including virtually accessible, remote administrative support.

The contactless necessities of the pandemic have made HCPs and patients more comfortable with virtual support services ─ including live, remote medical scribes and AI-based dictation programs. As additional virtual services, provided by highly trained professionals, become more accepted and cost efficient, more providers are taking advantage of them as an alternative to filling administrative positions in-house.

Virtual medical office services, customized to meet a medical practice’s or a health system’s needs, can optimize overall medical office management and boost revenue, while helping clinicians consistently deliver high-quality, attentive care.

There are many ways to utilize virtual medical office services to augment office staff:

Appointment Scheduling: Virtual teams receive incoming calls to make, reschedule, cancel, and confirm patient appointments, helping to reduce no-shows and cancellations, and optimize workflow.

Insurance Verification/Prior Authorization: Virtual staff can work with insurance companies to obtain approval for treatments, tests, and medications, which reduces delays in patient care and eases administrative staff burdens.

Chart Prepping: Professionals gather patient reports, results, and data from outside sources to prepare patient charts. This includes reviewing medical records and organizing relevant information to ensure accurate documentation. Their attention to detail streamlines the record-keeping process, allowing healthcare providers to focus on patient care.

Fax Management: Outsourcing management of incoming and outgoing faxes with a HIPAA-compliant team ensures prompt, efficient communication between a medical practice and its external entities, such as insurance companies, pharmacies, and other healthcare providers.

Patient Registration: A virtual support professional can register new patients by gathering demographic and insurance information, and maintaining updated records to ensure a smooth, welcoming experience with a new provider.

Efficient Call Center/Contact Services: A HIPAA-compliant, virtual medical office services team can handle incoming and outgoing calls, answer patient inquiries, respond to voicemails, and offer chat support to stay responsive to patient needs. Prompt, readily available calling and text messaging services can increase patient satisfaction levels.

Referral Coordination: Primary care providers need piece of mind knowing that referrals are scheduled, with authorization and that the relevant documents are available to the specialist. Virtual medical office support staff can schedule patients, arrange specialist appointments, obtain specialist’s reports, labs, or images, and upload these documents into the EHR.

Patient Follow-up: Virtual medical office services professionals can follow up with patients to encourage continuity of care, promote additional services, and help increase volume to maximize practice revenue and efficiency. 

Paper Chart Transcription: Transcribing paper charts into a digital format is a tedious process. A virtual medical office services team can take this on to make records more accessible, improve medical chart organization and reduce physical storage requirements.

Utilizing virtual medical office services to maximize revenue cycle management can be a game-changer for a medical practice, hospital, or healthcare network. Clinical staff can focus more on providing quality care with a team of highly skilled people available virtually to handle tasks like prior authorization, chart prep, and patient communication.

These offerings are expected to grow as providers face a greater need to bring in trusted, outside resources to fill gaps and enhance services to increase patient satisfaction, adhere to stringent requirements, and increase revenue.

Terry Ciesla is senior vice president of ScribeEMR, a leading provider of remote medical scribing and virtual medical office services headquartered in Woburn, Massachusetts.