Understanding the impact that the revenue cycle can deliver: With all of us being consumers of healthcare, we understand that the industry is continuously changing: the regulatory landscape adjusts to reflect lessons learned; patient demands change as people take greater responsibility for their own care; providers advance alongside new technology and research, and care delivery models alter based on societal needs.

Hospitals and provider groups must find ways to adapt to these changes, and the revenue cycle can be a vehicle to drive that change, given its unique position of serving three equally important clients: the patient, the enterprise and the payer.

To effectively be that agent of change, the revenue cycle structure and processes must be aligned to facilitate communication among patients, providers and payers, and the challenges and demands of these three clients must be understood to achieve this alignment.

Challenges and demands of serving the patients

Becoming the ambassador of the patient experience

The revenue cycle sets the tone for the patient experience, since it is often the patient's first and last point of contact with the enterprise. More importantly, the revenue cycle addresses one of the most important patient questions outside of care: What is my out-of-pocket cost?

With per capita out-of-pocket expenditure steadily rising, patients are finding themselves bearing more financial responsibility for the services and products they receive. As such, the way in which the patient (or the "customer") consumes healthcare is shifting. To address these shifts, revenue cycle leaders must consider:

  • Simplifying the process from pre-registration to payment by leveraging technology. Patients want to have a smooth, simple visit that is focused on their healthcare needs, not on registration and payment. Ideally, the patient experience will have them arrive, see the provider, schedule any follow-up visits and leave.

    The need for the patient to fill out information in the waiting room or take their wallet out at the end of each visit can be eliminated with an optimized prearrival process.

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