Category: Uncategorized

With a new year, comes new, uncharted waters for healthcare organizations, Navigating the financial seas of Federally Qualified Health Centers (FQHCs) can be quite the adventure. Let’s dive into some tips to help you chart a course toward long-term financial health. 

Understanding the FQHC Financial Landscape 

FQHCs are the backbone of primary care for over 31 million Americans, including many uninsured and low-income individuals. However, with costs rising faster than revenues, many centers are facing narrow or even negative profit margins. This financial squeeze makes effective long-range planning more crucial than ever. 

Key Elements of Long-Range Financial Planning 

To keep your FQHC financially sound, consider focusing on these areas: 

• Mission Alignment: Ensure your financial strategies support your core mission of serving underserved communities. This alignment helps in prioritizing investments that directly impact patient care. When you have a clear destination for where you want your organization to go, the path to get there becomes much clearer. 

• Revenue Forecasting: Analyze historical data and current trends to predict future revenue streams. If you know Medicaid reimbursements constitute a significant portion of income, staying informed about policy changes is essential.  

• Expense Management: Identify and control both fixed and variable costs. With personnel expenses making up about 75% of operating costs, efficient staffing is key. Taking a critical eye to your organizational chart could help you identify departments that are either over or understaffed and cross training staff during their onboarding makes department-level reorganizations smoother, giving you a more efficient in-house administrative team quickly. 

• Risk Management: Prepare for uncertainties like funding fluctuations and regulatory changes. Developing contingency plans can help mitigate these risks. 

Leveraging Benchmarking for Financial Planning 

Benchmarking is a powerful tool for evaluating and improving your FQHC’s financial health. It involves comparing your organization’s performance against industry standards to identify strengths, weaknesses, and opportunities for growth. Here’s how to make the most of benchmarking: 

• How to Do It: Start by collecting reliable internal data from your electronic health record (EHR) systems, financial reports, and revenue cycle metrics. Then, compare these numbers to publicly available benchmarks, such as those provided by the National Association of Community Health Centers (NACHC) or other industry groups. 

Metrics to Track: 

• Cost Per Visit: This metric helps you understand how efficiently resources are being used to deliver care. High costs per visit may indicate inefficiencies or excessive overhead. 

• Days in Accounts Receivable (AR): Measure how long it takes to collect payments. A lower number typically reflects an efficient billing process, which is crucial for cash flow. 

• Sliding Fee Discount Schedule Compliance: Ensure your organization adheres to federal guidelines while maximizing patient access and revenue. 

• Patient Volume Trends: Tracking changes in patient visits can help forecast future revenue and resource needs. 

• Why These Metrics Matter: These benchmarks provide a snapshot of your organization’s financial health and operational efficiency. They highlight areas needing immediate attention and guide strategic decision-making for long-term stability. Establishing regular review procedures for these metrics and keeping your eye on them throughout the year will help you determine where your FQHC currently stands financially and help you plot out your long-term financial path for 2025 and beyond. 

Tools and Strategies for Effective Planning 

• Implement Value-Based Care Initiatives: Transitioning to value-based payment models can enhance financial stability. Investing in systems that support this approach is beneficial, and getting a head start on gathering the data you need now will make the transition easier. Involve front desk staff to help you gather social drivers of health for your patient population and use that data to begin building your value-based payment system. Investing in policies, systems, and programs that support a value-based model will ensure your FQHC is financially ready for the upcoming shift. 

• Regular Audits: Conducting regular audits ensures you are in compliance with billing regulations and helps your team find areas that need improvement. Audits can uncover coding errors and show you the trends that are holding back your revenue cycle. Armed with this data, you can adjust and optimize your revenue cycles. If audits are not already a regular part of you financial year, schedule them now for 2025. 

• Engage Stakeholders: Involving team members across the organization fosters a culture of financial responsibility and ensures your team is aligned on strategic goals. This means getting perspective from your employees as well as leadership and board members. Changing policies and procedures with not just the valuable insight from your board, but also with the insight from the employees that are doing the tasks every day, means your new processes are much more likely to be effective and implemented seamlessly. 

Common Pitfalls and How to Avoid Them 

• Over-Reliance on Short-Term Solutions: While quick fixes may offer immediate relief, they can lead to long-term issues. Focus on sustainable strategies that may take longer to get right but ultimately promote long-term financial health. 

• Neglecting Workforce Investment: Workforce shortages are a significant challenge for FQHCs. Ensuring competitive compensation and professional development opportunities can improve staff retention and service quality. Helping your team feel confident in their daily tasks with regular and adequate training, and establishing a company culture of open communication results in employee buy-in as you adjust your revenue cycle procedures and adopt long-term changes. 

Why It Matters 

Robust financial planning enables FQHCs to reinvest in programs and patient care, ensuring the continued delivery of essential services to communities in need. By proactively managing finances, you can navigate challenges and seize opportunities for growth. 

What’s Next? 

Feeling the need for a financial check-up? Consider reaching out to experts who specialize in FQHC financial management. Services like revenue cycle assessments and financial audits can provide valuable insights. 

Long-range financial planning isn’t just about numbers; it’s about sustaining the mission of providing quality care to those who need it most. By focusing on strategic planning and leveraging available tools, you can steer your FQHC toward a prosperous future. 

Happy planning! 

Revenue leakage is a critical issue for healthcare organizations, leading to lost income and financial instability. Studies suggest hospitals lose an estimated 3-5% of net revenue annually due to leakage, amounting to billions of dollars industry-wide. It can stem from unbilled services, denied claims, or errors in patient billing. Addressing revenue leakage is vital to maintaining operational efficiency and ensuring the delivery of high-quality care. In this blog, we’ll explore practical strategies to prevent revenue leakage and highlight areas where Federally Qualified Health Centers (FQHCs) in particular face unique challenges. 

What Is Revenue Leakage? 

Revenue leakage occurs when a healthcare organization does not collect all the revenue it is entitled to for the services it provides. This silent drain on resources often arises from billing errors, missed charges, or denied claims. According to industry data, claim denials alone can account for 6-13% of potential revenue loss if not managed promptly. Understanding the concept of revenue leakage and its impact on your organization’s ability to grow is the first step in combating this issue. By addressing leakage, you can protect your financial health and enhance your sustainability. 

Common Sources of Revenue Leakage 

Understanding where your revenue leakage occurs is the first step in preventing it. Healthcare organizations often lose revenue due to overlooked or overcomplicated processes or inefficiencies. Identifying these areas makes it possible for leadership to take targeted action to address them effectively. 

• Under-coded or missed charges: Failing to capture all billable services means revenue left on the table. Since coding rules and procedures can change annually, keeping your team up to date on the latest coding standards for the services you provide can be a challenge. 

• Denied claims: Claims denied due to errors, missing information, or non-compliance. 

• Patient collections: Ineffective strategies for collecting co-pays and balances result in thousands of dollars of lost revenue. 

Research indicates that 90% of denied claims are preventable. This statistic highlights the importance of proactive measures when it comes to your billing practices. Regular audits and a clear understanding of your organization’s vulnerabilities can help mitigate revenue loss. 

Strengthening Your Charge Capture Process 

Charge capture is one of the most critical components of revenue cycle management. Mistakes in this area can lead to significant financial loss, but they are preventable with the right measures. A robust charge capture process ensures accurate billing for all services provided and minimizes errors. 

• Train staff regularly: Educate providers and billing staff on accurate charge capture. Make sure your whole team, from providers to administrators, understand the processes in place and how their responsibilities impact your organization’s overall financial health. 

• Review documentation: Conduct routine audits to identify and address missed charges. When you identify gaps in your procedures, brainstorm with your staff to get their input on how documentation processes could be simplified and improved. 

• Standardize workflows: Use checklists or templates to reduce variability in documentation. Providing your staff with these tools can help them avoid skipping steps on accident. 

Organizations that implement thorough charge capture protocols can significantly reduce errors and improve financial outcomes. 

Denial Management: Reducing Lost Revenue 

Denied claims are not just a financial burden—they’re also an opportunity for improvement. Research shows that the average cost to rework a denied claim is $25, underscoring the importance of preventing denials before they occur. With an effective denial management process, you and your team can recover lost revenue and prevent future denials. 

• Identify trends: Regularly analyze denials to uncover recurring issues. This can help you get a big picture of the areas that are consistently a challenge for your team. 

• Resolve quickly: Act on denials promptly to avoid exceeding payer deadlines. Work this quick action into your standard operating procedures. 

• Prevent future denials: Once you identify trends, use those insights to address the specific issues your team struggles with, and adjust processes and to improve compliance. 

Effective denial management not only boosts revenue but also strengthens organizational efficiency and compliance. 

Sliding Fee Discount Schedules: Addressing FQHC-Specific Revenue Challenges 

Sliding fee discount schedules are essential for making healthcare accessible in underserved communities. However, they present unique challenges for FQHCs in terms of revenue integrity. These programs must balance affordability for patients with financial sustainability for the organization. 

• Ensure accurate assessments: Train staff to consistently apply eligibility criteria across all locations and programs. 

• Audit regularly: Verify that discounts are correctly applied and documented. Training your staff regularly on these procedures can help ensure your team is familiar with the process and audits help you home in on specific areas that need your attention, instead of wasting valuable staff time retraining on areas that are working well. 

• Educate patients: Clearly communicate the benefits and expectations of sliding fee programs. When your patients feel listened to and also have a clear understanding of what is expected of them, they are better able to take advantage of the programs and services that will keep them healthy. 

When managed effectively, sliding fee discount schedules can enhance both patient satisfaction and organizational stability. 

Effective Patient Communication for Revenue Integrity 

Patient communication plays a crucial role in maintaining revenue integrity. Studies reveal that over 50% of patients are more likely to pay their bills when provided with clear cost estimates upfront. When patients understand their financial responsibilities, they are more likely to meet them, reducing instances of bad debt or delayed payments. Clear and consistent communication can make all the difference. 

• Provide detailed estimates: Give patients upfront cost estimates to avoid confusion. If payment plans are available, make sure they understand their options and payment schedules available. 

• Offer multiple payment options: Make it easy for patients to pay through various channels. Patients should be able to pay their bills in person, online, or over the phone, and the more payment methods you are able to accept, the more convenient and easy patient payments become. 

• Follow up consistently: Use reminders and follow-ups to encourage timely payments. These can be automated to decrease staff workload. 

By fostering transparency and trust, organizations can enhance their revenue cycle performance and patient satisfaction. Check out our guide on making patient payments easier for a deeper dive into this topic. 

Technology as a Tool, Not a Solution 

Technology can be a powerful ally in revenue cycle management, but it’s not a standalone solution. Combining technology with well-trained staff and strategic planning is the key to success. Automating processes like eligibility verification can reduce errors by up to 30%, making it a worthwhile focus area. 

• Use reporting tools: Leverage built-in analytics to identify trends and gaps. Most EHRs have robust reporting solutions that can provide valuable insights for your team. 

• Maximize automation: Automate repetitive tasks like eligibility verification. 

• Invest in training: Ensure your team knows how to use the tools effectively. Training your team regularly keeps the processes and procedures top of mind and ensuring that training is a part of onboarding for new staff will keep processes running smoothly. 

When used wisely, technology enhances efficiency without replacing the need for human expertise. 

Partnering for Success 

Addressing revenue leakage can feel overwhelming, but it doesn’t have to be. By partnering with experts, healthcare organizations can gain valuable insights and support to strengthen their revenue cycle processes. Industry data suggests that organizations partnering with RCM experts recover up to 15% more in lost revenue. Collaboration with experienced professionals ensures that no stone is left unturned in the pursuit of financial integrity. 

At Practice Management, we specialize in billing department assessments and audits that identify weak points and opportunities for improvement. By partnering with experts, you can safeguard your organization’s revenue and focus on delivering exceptional care. 

Preventing revenue leakage requires diligence, proactive strategies, and a commitment to continuous improvement. By addressing common sources of leakage and leveraging your resources effectively, your organization can maintain financial health and continue serving your community.  

Revenue Cycle Management (RCM) is at the heart of every healthcare organization’s financial success. But optimizing RCM processes is a complex task that requires coordination between healthcare providers, payers, and vendors. By fostering collaboration, organizations can streamline workflows, reduce denials, and improve revenue outcomes while remaining focused on their mission of providing excellent patient care. Let’s explore how strong partnerships can enhance RCM and drive financial health for your organization. 

Why Collaboration Matters in RCM 

Effective RCM is not a solo endeavor. It thrives on collaboration and runs smoothly when providers, payers, and vendors all work together. Each stakeholder has a unique perspective and role in the process, which means teamwork is essential to ensure accurate billing, timely reimbursements, and sustainable financial performance. 

When collaboration is a focus for your billing, you’ll see: 

• Faster claim resolution: Shared insights and open communication help reduce errors and speed up approvals. 

• Improved relationships with payers: A partnership approach builds trust and fosters long-term cooperation. 

• Higher accuracy in billing: Collaboration ensures everyone aligns on codes, policies, and payment expectations. 

With collaboration as the foundation, your organization can turn RCM challenges into opportunities for growth and sustainable revenue. 

Engaging with Payers: Creating Win-Win Scenarios 

Building a strong relationship with payers is critical to optimizing your revenue cycle. A cooperative approach can reduce denial rates, improve cash flow, and minimize administrative burden. 

Here’s how to foster better payer relationships: 

• Maintain open lines of communication: Regularly engage with payer representatives to address issues before they escalate. Being proactive goes a long way towards building good relationships! 

• Stay informed on policies: Collaborate on understanding contract terms and changes to avoid surprises across departments. Your billing team should be up to date of course, but keeping providers educated and informed as well helps keep your billing running smoothly. 

• Use data to build trust: Share metrics that highlight mutual successes, such as reduced claim turnaround times or increased payment accuracy. Use team meetings as a chance to shine a light on different departments working together well and how their teamwork has created an organization-wide impact. 

When healthcare teams and payers work together, the result is a streamlined process that benefits both sides—and ultimately, the patient. 

Partnering with Vendors: Strengthening Support Systems 

Vendors play a crucial role in supporting RCM workflows, whether through technology, consulting, or outsourcing services. Choosing the right vendors and establishing a collaborative relationship can greatly enhance efficiency and outcomes while reducing overall stress and workload for your in-house team. 

Strategies for effective vendor collaboration include: 

• Define clear expectations: Set benchmarks for performance and ensure regular reporting. Let your vendors know what metrics matter the most to you from the beginning, and make sure they can pull reports that are meaningful and easy to interpret. 

• Leverage expertise: Tap into vendor insights to identify areas for improvement in your processes. Your vendors are experts at what they do and periodically asking them for informal or formal reviews and suggestions can tap into that extensive knowledge and help your team address potential blind spots in your RCM processes. 

• Collaborate on solutions: Work together to address issues like aging accounts receivable or coding inaccuracies. Bringing in vendors, whether it’s a new EHR, an outsourcing partner, or a consulting firm, means you are looking for solutions. Once a new vendor is onboard, make sure you’re communicating regularly and working together to address your paint points. Collaborating here helps you identify what areas are the responsibility of the vendor, and what areas your team needs to address and adjust internally. 

By putting in the time to find a vendor that meshes with your company culture and treating vendors as partners rather than just service providers, you’ll create a relationship that drives results and supports your financial goals. 

Collaboration doesn’t just happen externally—it starts within your own organization. Encouraging teamwork among billing staff, clinicians, and administrators can make a significant impact on your revenue cycle. Check out our blog for more tips on fostering a company culture that will attract and create team players. 

Practical tips for fostering internal collaboration: 

• Hold regular cross-department meetings: Discuss pain points, share updates, and align on goals across departments. Allocate time at each meeting for every department to address specific challenges they are facing and encourage brainstorming together in real-time. 

• Invest in staff education: Provide training on the latest RCM practices and payer policies. Ask your team what they would like to learn more about and where they feel their educational gaps are – this can give you direction on the types of training that would create the biggest impact. There are abundant educational resources available at state and national conferences, as well as online at paid and free virtual training sessions. Our free resource library is a great place to start! 

• Celebrate successes: Recognize team achievements to boost morale and encourage continued effort. Set aside time during staff meetings to shout-out employees that are going above and beyond! And make sure to recognize hard work internally in person and in digital communication when appropriate. 

An engaged and informed team that feels appreciated is more likely to work together effectively, ensuring your RCM processes are as efficient as possible. 

RCM can be complex, and juggling collaboration with day-to-day responsibilities may feel daunting. That’s where outsourcing can help. Partnering with experts in RCM allows your organization to focus on patient care while providing you with a sustainable revenue stream generated by your own programs and services. 

At Practice Management, we specialize in: 

• Billing department assessments to identify workflow inefficiencies. 

• Comprehensive RCM services tailored to your organization’s needs. 

• Consulting and credentialing to optimize your revenue streams. 

If you’re ready to take your RCM to the next level, we’re here to help. Together, we can build a stronger foundation for your financial success. 

By prioritizing collaboration at every level—internally and externally—you’ll unlock new opportunities to optimize your revenue cycle. Stronger partnerships lead to more accurate claims, faster payments, and a more sustainable financial future, which mean you can create even healthier communities for your patients. 

Healthcare organizations, especially Federally Qualified Health Centers, have a profound opportunity to drive meaningful social change. By proactively addressing health disparities and promoting equitable access to care, they can create lasting impact in underserved communities where it matters the most. But making a difference requires intentional strategies, thoughtful collaboration, and a deep understanding of what your community needs. Today we’re exploring ideas to help your organization effectively bridge these gaps and become a true catalyst for change. 

Understanding Health Disparities 

Health disparities are more than statistics—they represent real challenges faced by individuals in your community. From socioeconomic barriers to systemic inequities, these disparities affect access to quality care and contribute to poor health outcomes. As an FQHC, understanding the specific issues in your community is the first step in developing targeted, impactful solutions. 

Key Steps: 

• Conduct Community Assessments: Regularly evaluate the specific needs of your patient population. This helps you tailor programs to address the unique challenges your community is facing. This could be a good opportunity to reach out to other organizations and nonprofits providing programming for your patient population and share the biggest needs each team is seeing in the individuals and families they serve. 

• Engage Patients Directly: Talk to your patients! Collect feedback to understand barriers they face, from transportation issues to language barriers. 

• Track Health Outcomes: Use data to measure the impact of your initiatives, adjusting them to better serve your community. The more you can report on programmatic impacts, the better you understand the strengths and weaknesses of your services, and the better you are able to adjust and advocate for your programs. 

Building Partnerships for Impact 

No healthcare organization can solve complex social issues alone. Building strategic partnerships with local organizations, schools, and nonprofits allows you to amplify your reach and pool resources for greater impact. These collaborations can lead to holistic solutions that address the root causes of health disparities, not just the symptoms. 

Ideas for Collaboration: 

• Community Health Initiatives: Look for partners that are already making a difference in your community in ways that directly affect health outcomes. For example, try working with food banks to address nutrition insecurity or partner with housing services to tackle homelessness. 

• Educational Programs: Team up with schools to provide health education and preventive care to all ages. Teaching children and teens how to proactively care for their health creates healthier adults later in life, and partnering with schools means you also can educate parents on the availability of healthcare for their families, even for the uninsured. 

• Support Networks: Create alliances with mental health organizations to offer comprehensive care options. Building strategic partnerships in this area can help you expand the services you offer without requiring you to hire and train new staff. 

Strong partnerships not only enhance patient well-being but also foster community trust and engagement. 

Innovative Programs for Community Health 

Innovation doesn’t always mean high-tech solutions. Sometimes, the most impactful programs are those that address basic needs in creative ways. Implementing innovative, patient-centered initiatives tailored to your community’s unique challenges can create significant improvements in health outcomes and equity. 

Examples to Explore: 

• Mobile Clinics: Extend services to remote or underserved areas, making healthcare accessible to those who need it most. Curious about how to sustain this new initiative? Check out our webinar on billing best practices for mobile clinics – billing correctly for these services gives you reliable revenue to reinvest and continue to grow. 

• Telehealth Services: Provide care options for patients who face transportation barriers or have limited mobility. This has become an increasingly common method of healthcare delivery since 2020 and shows no signs of slowing down. 

• Sliding Fee Scale Programs: Ensure that financial limitations don’t prevent access to care, promoting equity and inclusivity. This is standard practice for most FQHCs, but other healthcare organizations can also consider offering this option to expand the individuals and families you are able to serve. 

Focusing on practical, community-driven programs can transform the way your FQHC serves its patients. 

Leveraging Revenue Cycle Management for Community Initiatives 

Effective revenue management is more than a financial necessity—it’s a powerful tool for social impact. When your revenue cycle runs smoothly, you can reinvest resources into the programs and services that matter most. Streamlined RCM processes can enhance your ability to fund community initiatives while reducing the administrative burden on your hardworking staff. 

RCM Benefits: 

• Sustainable Funding: Strong RCM practices help you recover more revenue, which can fund outreach programs and patient services. FQHCs rely on many revenue streams that are not always guaranteed to renew, like grants or special funding programs. Optimizing your RCM means you can create a revenue stream based on your own services, making it a predictable and sustainable source of funding. 

• Reducing Staff Burnout: Outsourcing tasks like AR cleanup or billing audits can lighten your team’s workload, allowing them to focus more on patient care. 

• Enhancing Efficiency: Optimized billing and credentialing processes ensure that care delivery remains smooth and financially sustainable. When you outsource services like these, you are giving your organization access to an entire team of experts that are dedicated to the best billing practices instead of asking your (oftentimes overworked) staff to wear yet another hat. You get expertise without having to onboard and pay another staff member, and your current workforce gets tedious and time-consuming tasks taken off their plate. 

By strengthening your financial operations, you create a foundation for more impactful community work. 

Supporting Your Team: The Foundation of Social Change 

Your staff are the backbone of your organization and the key to delivering quality care. Ensuring their well-being isn’t just good for morale—it’s essential for sustainable success. When your team feels supported and valued, they are better equipped to serve patients and contribute to positive social change. 

Ways to Support Staff: 

• Provide Training: Equip them with the tools and knowledge to address social determinants of health. Give them what they need to make a difference! 

• Promote Work-Life Balance: Implement wellness programs to reduce burnout and improve morale. Looking for practical ideas? Check out our social media pages for our monthly Wellness Wednesdays or read our blog full of ideas to help prioritize employee wellness at your healthcare organization. 

• Encourage Community Involvement: Offer paid time for staff to volunteer in community initiatives. This keeps your staff connected to their local community and shows that you value the initiatives that are important to them! 

Healthy, motivated employees drive better outcomes for patients and strengthen your mission. 

Addressing community health disparities isn’t just a moral imperative—it’s a strategic one. By understanding local challenges, building strong partnerships, and leveraging innovative programs, FQHCs and other healthcare organizations can become true catalysts for social change. With strong RCM practices, these efforts become more sustainable and impactful, allowing you to focus on what matters most: building healthier, more equitable communities. 

Ready to enhance your impact? Our team can help optimize your RCM and billing processes, so you can focus on serving your community to the fullest. Contact us here to get started or check out our FAQ page to learn more about the process. 

The healthcare industry, especially FQHCs, are dedicated to making a difference for their communities, but this industry is also known for its demanding work schedules, high-pressure environments, and the emotional toll it takes on workers. For executives and managers, it’s vital to support staff who may be struggling to find balance between their work and personal lives. Work-life harmony isn’t just about making employees happy; it’s essential for maintaining long-term staff retention, well-being, and productivity. Creating a work environment that supports your employees can also be a big draw to help you attract top talent to your workforce in an increasingly competitive job market. 

In this blog, we’ll explore strategies you can use to help your team achieve work-life balance, including practical self-care tips, time management tools, and the benefits of outsourcing where you can to help reduce workload.  

The Unique Challenges of Healthcare Work  

Healthcare professionals face unique challenges that make achieving work-life harmony difficult. Long shifts, unpredictable schedules, and the emotional weight of patient care all contribute to burnout and stress. 

• Unpredictable Schedules: Healthcare workers often have rotating or irregular shifts, making it hard to maintain routines outside of work. 

• Emotional Exhaustion: Dealing with patients’ physical, mental and emotional health and sometimes difficult outcomes can weigh heavily on healthcare providers. 

• High Job Demands: The sheer volume of tasks—from patient care to administrative work—can be overwhelming, especially when healthcare workers are expected to wear multiple hats. 

As a leader, recognizing these challenges and taking proactive steps to address them before they create burnout is key to building a supportive and productive workplace. 

Practical Self-Care Strategies 

Self-care is crucial for healthcare professionals to recharge and maintain their well-being. Educating your staff on the importance of self-care and encouraging employees to take time for themselves can improve overall job satisfaction and performance. 

• Encourage Breaks: As a manager in the healthcare space, strive to create a culture where breaks are not only allowed but encouraged. Breaks don’t have to be long to make a difference for employee mental health. For example, a 5-10 minute walk can reduce stress and improve focus. 

• Provide Mental Health Resources: Offer access to counseling services, meditation apps, or wellness programs. Mental health should be part of your overall employee care strategy. 

• Flexible Scheduling: Whenever possible, provide options for flexible scheduling or shift swaps to allow staff to attend to personal matters and recharge outside of work. 

Managing Workloads with Technology 

Incorporating technology can make a significant difference in managing workloads and streamlining tasks, helping your employees focus on what matters most – providing your patients with amazing care. 

• Time Management Tools: Tools like Trello, Asana, or even just simple calendar apps with good categorization can help staff stay organized and reduce the mental strain of keeping track of multiple tasks. 

• EHR Optimization: You might be underutilizing your EHR! Most electronic health record systems have features that allow for integrating patient information and streamlining documentation. Features like automated reminders or templates for charting can save hours of work. Take some time to explore and familiarize yourself with your EHR capabilities, implement them into your processes and procedures, and train all staff on the updates.  

• Task Automation: Consider using automation for routine administrative tasks, such as appointment reminders, billing notifications, and claim follow-ups, to free up time for more critical patient-focused work.  

The Benefits of Outsourcing RCM or AR Cleanup 

One way to significantly reduce the burden on your staff is by outsourcing services that make sense for your organization. Many healthcare organizations are hesitant to outsource services like RCM or AR Cleanup, but these areas are often resource-heavy, pulling staff away from patient care and leading to longer work hours or higher stress levels. Finding a great outsourcing partner that gels with your team can make a huge difference in the stress of your staff, and help you retain the best providers.  

• Increased Revenue Without Overloading Staff: Outsourcing your RCM or AR cleanup gives you access to the best professionals with dedicated expertise in managing complex billing tasks. This not only leads to faster payments and fewer denials but also allows your internal team to focus on patient care rather than tedious billing tasks. 

• Reduce Burnout: When your internal team isn’t overwhelmed by financial tasks, they have more energy to devote to their core responsibilities. This can significantly reduce burnout and improve overall staff morale. 

• Specialized Expertise: By outsourcing some of these financial processes, you’re bringing in specialized teams that understand how to streamline billing and AR management for your specific state and specialty. FQHCs in particular have unique billing needs, and finding an outsourcing company that understands those needs is vital. They can fix gaps in your current process and improve cash flow, helping your organization thrive without increasing the burden on internal staff. 

Mental Health Resources for Healthcare Workers 

Supporting mental health in your staff should be a top priority, but it doesn’t have to be overly compliacted. Providing resources can go a long way in helping your team maintain balance and mental well-being. Here are a few resources that have worked well for healthcare organizations: 

• Headspace: A popular app offering meditation and mindfulness practices designed to reduce stress and improve focus. 

• National Alliance on Mental Illness (NAMI): Provides education, support, and resources for individuals struggling with mental health issues. 

• The Emotional PPE Project: Specifically for healthcare workers, this project connects those in need with licensed mental health professionals offering free support. 

By making mental health a central focus of your wellness programs for staff, you signal to employees that their well-being is just as important as the work they do. 

Low-lift ways to Promote Work-Life Balance 

We’ve covered a lot of ground in this post, and if you’re struggling with high rates of burnout or turnover, these recommendations can feel overwhelming. But when trying to create a culture shift for your organization, sometimes small changes can have the biggest impact. Here are a few practical tips you can implement quickly to help your team maintain work-life balance: 

• Set Clear Expectations: Communicate when it’s okay to disconnect from work, especially outside of scheduled hours. Encourage staff not to check emails or answer work calls during their time off. 

• Create a Culture of Support: Managers should check in regularly with their teams, not just about work but also about how they’re doing personally. This creates an open environment where employees feel supported. 

• Offer Wellness Incentives: Simple incentives like wellness challenges, discounts on gym memberships, or mindfulness workshops can make a big difference in helping your team prioritize their health. 

Achieving work-life harmony in the healthcare industry is no easy task. But by leveraging technology, offering self-care strategies, and outsourcing heavy administrative burdens like RCM, you can create a healthier work environment. Remember, your staff’s well-being directly impacts your organization’s success. Supporting them in finding balance ensures happier employees and better patient care. 

If you’re interested in learning more about how outsourcing your RCM or AR cleanup can improve your team’s well-being, we offer billing department assessments and consultations. We’re here to help you streamline processes, optimize workflows, and ultimately create a workplace that supports your entire team. 

Optimizing revenue isn’t just about your bottom line – bringing in more of your hard earned revenue means more resources to invest in growing your staff, improving your technology, and expanding your service area. It is also essential if your healthcare organization wants to maintain financial stability, reduce administrative burdens, and ensure efficient operations. So many organizations we work with put off really digging into their revenue workflows because they feel they don’t have the time. But improving these processes doesn’t have to be time-consuming or costly! Here are some practical tips you can implement right away, without needing to invest in new software or overhaul your entire system. 

Streamlining Billing Processes 

Efficient billing processes are at the heart of a well-functioning revenue cycle. When your billing is streamlined, cash flow improves, and your organization can operate more smoothly. But inefficiencies in billing can quickly lead to financial bottlenecks. Here’s how to make sure your billing processes are running smoothly: 

• Standardize Billing Procedures: Create clear and consistent procedures for all billing tasks. This helps reduce errors and ensures that everyone on your team is following the same process. Make sure these procedures are memorialized somewhere that all billing staff have access to.  

• Regularly Review and Update Codes: Keep your coding practices up-to-date to avoid denials. Schedule regular reviews of codes to ensure accuracy and compliance with the latest regulations. Looking for some guidance? Check out our September webinar or our Resource Library for free educational resources! 

• Set Up Alerts for Missing Information: Use your EHR system to set alerts for any missing or incorrect patient information before billing. This can reduce rejections and speed up the payment process. Utilizing the technology you already have available is a great way to optimize current processes without adding administrative bulk. 

Improving Claims Management 

Effective claims management is crucial to reducing delays and boosting revenue collection. When claims are managed efficiently, it reduces the likelihood of denials and ensures quicker payment. Here are some practical tips to tackling your claims management: 

• Track Claim Status: Keep a close eye on claims as they move through the process. Regular monitoring allows you to spot and address issues before they become bigger problems. 

• Train Staff on Common Denial Reasons: Educate your team on the most frequent reasons for claim denials and how to prevent them. This proactive approach can save time and reduce frustration for both staff and patients. Check out this webinar on demand to learn about common denials for Medicare in FQHCs. 

• Implement a Claims Scrubbing Process: Use a claims scrubbing process to catch errors before submission. This could include an automated check for common errors like duplicate claims, a manual review by staff to check for application of custom rules, or setting up error alerts for real-time feedback for billers. This reduces the chances of denials and speeds up the approval process. 

Enhancing Communication and Coordination 

Good communication and coordination are vital for a smooth revenue cycle. When your team is on the same page, it’s easier to manage tasks and keep everything running efficiently. A lot of this communication style is set up through company culture, but even if your organization struggles with open communication, establishing clear and easy communication channels for your billing team can make a world of difference in revenue cycle optimization. Consider these strategies: 

• Hold Regular Team Meetings: Regular check-ins help keep everyone informed and aligned with your organization’s goals. These meetings can be a great time to discuss challenges, share updates, get feedback on your current processes, and plan for the future. 

• Use EHR Features for Task Management: Many EHR systems have built-in tools for assigning and tracking tasks. Leveraging these features can help keep your team organized and ensure that nothing falls through the cracks. 

• Create a Centralized Communication Hub: Establish a central location for all communication, such as a shared platform or intranet. This ensures that all team members have access to the same information and can collaborate effectively. Model usage of this hub as a leader, using it often and regularly to update staff and communicate important information. 

Utilizing EHR and AI Features 

Technology doesn’t have to mean expensive new software. Many organizations already have powerful tools at their disposal, but they aren’t fully utilizing them. EHR and AI can significantly enhance your workflows if used effectively: 

• Automate Routine Tasks with EHR: Use the automation features in your EHR to handle repetitive tasks like appointment reminders or billing alerts. This frees up your team to focus on more complex issues. 

• Consider AI for Predictive Analytics: Some EHR systems include AI tools that can predict trends and help you adjust workflows. Even small adjustments based on predictive data can have a big impact on your efficiency. 

• Utilize EHR Reporting Tools: Make use of the reporting tools in your EHR to track performance metrics. Regularly reviewing these reports and taking the time up-front to customize the reports to fit your needs can help identify inefficiencies and guide improvements in your workflows. 

Prioritizing Staff Training and Development 

Your team is one of your most valuable assets, and investing in their development can lead to significant workflow improvements. Continuous training ensures your staff remains competent and confident in their roles: 

• Offer Regular Training Sessions: Make sure your staff is up-to-date on the latest industry standards and best practices. Regular training sessions can improve skills and introduce new techniques that enhance productivity. Bringing in an expert to do customized training for your team is a great option! But there are a lot of wonderful, free resources available as well. Check out NACHC’s website for their webinar offering or check out our live webinar calendar here. 

• Encourage Cross-Training: Cross-training allows your team to be flexible and fill in for each other when necessary. This ensures that critical tasks are always covered, even if someone is out of the office, and helps you build a deep bench. 

• Create a Mentorship Program: Establish a mentorship program where experienced staff can guide newer employees. This helps build a stronger, more cohesive team and ensures internal knowledge is passed on effectively. 

Optimizing your revenue cycle workflows doesn’t have to be overwhelming or expensive. By implementing these practical tips, you can make significant improvements with minimal disruption and build a stronger team that works well together. If the idea of diving into your workflows feels daunting, we’d love to help! Check out our billing department assessments and consulting services – we’d love to connect and help you get your operations running as efficiently as possible. 

Effectively managing your revenue cycle is more important than ever. Benchmarking is a crucial tool that allows healthcare organizations to evaluate their revenue cycle performance against industry standards, identify areas for improvement, and set realistic financial goals. This process not only helps optimize financial operations but also enhances your overall organizational success. In this blog, we’ll explore the importance of benchmarking in healthcare revenue cycle management, highlight key performance indicators that deliver meaningful data about your revenue cycle, and address common challenges faced during implementation for all healthcare organizations.  

FQHCs are unique in their own way, and we’ve got you covered too! Let’s dive in. 

The Importance of Benchmarking in Healthcare RCM 

You can’t improve what you’re not measuring, which makes benchmarking a powerful strategy for optimizing the efficiency and effectiveness of your RCM processes. By comparing your organization’s performance to industry standards, and to your own performance year over year, you can gain valuable insights into where you stand and where you can improve. This process helps identify gaps, inefficiencies, and areas that require immediate attention, keeping your financial operations aligned with best practices. 

Working with healthcare organizations nationwide, we find they often struggle with maintaining consistent cash flow and minimizing the time it takes to collect payments. Without proper benchmarking, it’s easy to overlook issues that could be costing your organization significant revenue. By regularly benchmarking key metrics, you can proactively address these issues and enhance your overall financial performance. Additionally, benchmarking supports informed decision-making, enabling leadership to implement changes that drive improvement and long-term success, allowing you to focus on keeping your community healthy and happy. 

Key Performance Indicators (KPIs) to Monitor 

As you begin to tackle practical ways to measure the performance of your revenue cycle, certain KPIs begin to stand out as critical measures of success. Monitoring these metrics allows you to pinpoint your team’s strengths and weaknesses, and helps you figure out if your financial operations are running efficiently. 

• Days in Accounts Receivable (AR): This metric measures the average number of days it takes to collect payments after a service is provided. A lower number indicates a more efficient revenue cycle. While the “optimal” age of AR can vary depending on the type of organization, payer mix, and other factors, a generally accepted benchmark for aging AR is 30 – 40 days. If you find that your AR is regularly aging past this benchmark, it could signal inefficiencies in your revenue cycle. 

• Net Collection Rate: This KPI shows the percentage of collectible revenue that your organization is actually collecting. A higher rate signifies effective revenue cycle processes, meaning your bringing in the hard-earned revenue you deserve. A lower rate means it is time to examine your billing procedures, coding accuracy, staff training, or patient communication procedures. 

• Denial Rate: The percentage of claims denied by payers is a crucial indicator. A low denial rate suggests that claims are being processed correctly and efficiently. Industry experts recommend aiming for a denial rate of 3 – 5% – anything higher than that could indicate issues with your current workflows. According to one study, the top causes of denials are issues with authorizations, provider ineligibility and coding errors. Monitoring this benchmark helps you identify the gaps your organization needs to address. 

• Cost to Collect: This metric reflects the total cost of collecting payments as a percentage of total revenue. Costs vary across organization types, medical specialties, and even states, but keeping this cost low is essential for maintaining profitability. 

By regularly tracking these KPIs, you can paint a clear picture of your revenue cycle performance and make data-driven decisions to improve financial outcomes. 

Common Challenges in Implementing Benchmarking 

Implementing benchmarking in healthcare RCM isn’t without its challenges. Many organizations struggle with the initial setup and ongoing maintenance required to effectively benchmark their performance. Some common challenges include: 

• Data Collection and Accuracy: Gathering accurate and comprehensive data can be time intensive, but inaccurate data can lead to misleading benchmarks and hinder improvement efforts. 

• Resource Constraints: Limited resources, such as staff and technology, can make it challenging to maintain consistent benchmarking practices. 

• Resistance to Change: Staff and leadership may resist changes that benchmarking data is suggesting, especially if those changes require significant adjustments to current workflows. 

Overcoming these challenges requires a commitment from leadership to prioritize benchmarking as an essential part of your organization’s financial strategy. If you have any holdouts on your leadership team, take some time to gather and present solid research backing the importance of the KPIs you want to measure, and lay out step-by-step plans for each adjustment the data recommends. Taking the time to allay fears, get everyone on the same page, and address hurdles head-on will enable your team to successfully implement benchmarking and realize its full benefits. 

Benchmarking for FQHCs: Unique Considerations 

Federally Qualified Health Centers face unique challenges in managing their revenue cycle, making benchmarking a particularly valuable tool. FQHCs often serve diverse and underserved populations, leading to complexities in billing and collections that other healthcare organizations don’t have to address. 

For FQHCs, key metrics such as the Sliding Fee Discount Schedule Utilization (how effectively you are providing reduced fees to low-income patients) and Grant Fund Reporting Accuracy (how precisely you use grant funds in compliance wiht federal and state requirements) are particularly important and unique to FQHCs. These metrics help ensure that the financial operations are aligned with your mission of providing affordable care while maintaining financial sustainability. Additionally, FQHCs should consider benchmarking Patient Payment Collection Rates, which can be more challenging due to the financial situations of their patient populations. Check out our guide on Making Patient Payments Easier for ideas on improving this benchmark. 

Benchmarking also helps FQHCs find areas where they can streamline processes, reduce costs, and improve patient payment experiences. FQHCs are often bogged down by paperwork and processes, and prioritizing examining your procedures and results with a critical eye can help you marry your mission and your finances. 

Benchmarking and Outsourcing RCM 

For some healthcare organizations, and especially FQHCs, the complexities of managing your own RCM, benchmarking progress, adjusting procedures, and protecting staff well-being while providing quality care to your community can be overwhelming. Relying solely on internal resources to manage these processes can strain your team’s capacity and limit your ability to achieve optimal financial performance. If you feel like your organization is struggling to find this balance, it might be time to explore outsourcing all or part of your RCM. 

Outsourcing RCM gives you access to the expertise of specialized professionals who are well-versed in industry best practices and know your specialty and state inside and out. This can lead to increased revenue through more efficient billing and collections processes. Outsourcing can also free up your internal staff to focus on patient care and other critical tasks, rather than getting bogged down in administrative details. By partnering with an experienced RCM provider, you can improve your financial health while continuing to deliver high-quality care.  

This isn’t the right fit for every organization, but if you’re wondering if it’s right for your team, check out our free download to help you figure out if outsourcing is right for your organization, or check out this blog to learn what to look for in an outsourcing company.  

Benchmarking in healthcare RCM is a vital practice that enables organizations to measure performance, identify opportunities for improvement, and set realistic financial goals. By focusing on the key metrics that matter the most to your organization and patient population and addressing challenges head on, you can enhance your organization’s revenue cycle processes and achieve long-term financial success. If you’re ready to improve your RCM or assess your current processes, contact us to learn how we can help your organization reach its full potential. 

What happens when you’re working with a Chief Financial Officer that refuses to embrace the modern ways that healthcare is changing? If you’re a mid-level leader or financial professional working in an FQHC, navigating your position can be challenging, especially if your CFO prefers old-fashioned methods. This kind of environment can feel limiting when you’re eager to push forward with modern approaches and excited about the ways technology and new programs can impact the health of your community. Balancing respect for traditional practices with the need for innovation is tricky but essential if you want your FQHC to thrive. Today we’re exploring some practical tips for moving your FQHC forward, even when your CFO sticks to their old ways. 

Understanding the Dynamics 

If your CFO is more traditional, understanding their perspective is the key to working with them successfully. These leaders often rely on conventional methods they’ve seen work in the past. They may be resistant to change and prefer established practices over new innovations. This reliance on the familiar doesn’t mean your CFO is trying to keep your organization from growing and changing. Usually, it comes from a place of security and a deep love for their team, their community, and their programs. New technology and evolving industry standards can feel like a threat to an old-fashioned CFO who only wants to protect their FQHC and continue to provide services in ways they know work.  

However, an aversion to adapting slows down the adoption of new technologies, policies and methods, which could cause your organization to fall behind. Understanding these dynamics helps you work with your CFO from a place of empathy and practicality. 

Managing Resistance to Change 

Resistance to change is common, especially in organizations with a traditional mindset. As we mentioned, it’s important to understand the reasons behind this resistance. It could be fear of the unknown, concerns about costs, or attachment to familiar routines. Addressing these concerns is key to overcoming resistance.  

Building a Strong Relationship with the CFO 

The importance of creating a solid relationship with your CFO cannot be overstated. Good communication and mutual respect are essential! Start every interaction with your CFO with respect – even the interactions that you know will result in disagreements. As you work together on new projects and make suggestions for adopting modern methods, make an effort to find common ground and focus on your shared goals. Remember that you’re both working towards the growth of your FQHC and the health of your community.  

Regular and effective communication also helps build trust. When presenting new ideas that may challenge traditional methods, use data and evidence to support your proposals. Encourage questions and dialogue and be ready and willing to address questions and concerns that may require additional research or even repetition. Patience is key here, and will help your relationship with your CFO grow! Highlight the benefits of new ideas and procedures without undermining your current practices and suggest piloting new initiatives on a small scale to get your leadership comfortable and troubleshoot any potential challenges. 

Tips for Building a Strong Relationship: 

• Show Respect: Acknowledge their experience and achievements. 

• Find Common Ground: Identify shared goals and objectives. 

• Communicate Effectively: Use regular meetings, reports, and updates. 

• Present Data-Driven Proposals: Use evidence to support your ideas and be open to questions. 

• Suggest Small-Scale Pilots: Propose testing new initiatives on a limited basis. 

Navigating Financial Management 

Dealing with an old-fashioned CFO can be tough, especially if they’re stuck on outdated financial techniques. They might prefer manual accounting processes and resist automation. This focus on cost-cutting over strategic investments can hold back the organization. To modernize financial management, introduce the benefits of modern financial software. Advocate for small, incremental changes and emphasize the importance of data-driven decision-making. For example, streamline billing processes with new software or implement more accurate financial reporting methods. 

Modernizing Financial Management: 

• Introduce Financial Software: Highlight efficiency and accuracy improvements. 

• Advocate for Incremental Changes: Suggest small, manageable updates. 

• Emphasize Data-Driven Decisions: Use analytics to guide financial strategies. 

• Streamline Billing Processes: Implement software to automate and simplify billing. 

• Improve Financial Reporting: Use modern tools for more accurate and timely reports. 

Leveraging Middle Management Influence 

As a mid-level leader, you have more influence than you might think. Your role is crucial in driving change within the organization. Start by building a coalition of support among your peers and other departments. Talk to others and try to understand challenges they’re facing and what new technology or procedures they are interested in exploring. Collaborating and listening means you’ll have a wider network of support and greater buy-in as you advocate for exploring the latest best-practices with your CFO. Lead by example by implementing small-scale improvements within your team. Share your successes and lessons learned with the CFO and other leaders – showing your wins and the ways your team overcomes challenges helps build trust and confidence in modern procedures. 

Continuous learning and professional development are also important. Staying updated on industry trends and best practices will help you bring fresh ideas and perspectives to your organization, along with the knowledge and understanding to back up your ideas. 

Leveraging Your Influence: 

• Build a Support Network: Collaborate with peers and other departments. Listen to their unique pain points to ensure your recommendations benefit the organization as a whole, not just your department. 

• Lead by Example: Implement and showcase small-scale improvements. 

• Share Successes: Communicate achievements and lessons learned. 

• Pursue Professional Development: Stay current with industry trends and best practices. 

Balancing tradition with innovation is essential for the success of your FQHC. Working with an old-fashioned CFO may feel frustrating at times, but leading with respect and data-driven suggestions can help you merge classic techniques with modern best-practices. It takes patience, persistence, and adaptability, but the rewards are worth it. As a mid-level leader, you play a vital role in advocating for positive change and ensuring the future success of your FQHC! 

Healthcare workers are called heroes for a reason! Healthcare employees face unique stressors and challenges, from long hours and emotional strain to high-stakes decision-making, the pressures can be immense. Whether you’re an FQHC, hospital, or group practice, your employees are the heartbeat of your organization. Prioritizing their wellbeing makes your organization stronger and helps you attract top talent. Implementing wellness programs is an essential way to support the dedicated professionals on your team, enhancing their job satisfaction, and helping your organization thrive. 

Understanding the Stressors and Challenges 

Healthcare professionals work in high-pressure environments. They often deal with life-and-death situations, which can lead to burnout and stress. Even outside of the hospital setting, employees at FQHCs and Group Practices face a constant demand for excellence, long shifts, and emotional exhaustion. Recognizing these stressors is the first step in addressing your employee well-being effectively. 

Impact of Employee Well-being on Organizational Success 

Employee well-being directly impacts job satisfaction and retention. Happy, healthy employees are more productive, engaged, and loyal to your organization, which helps them keep your community healthy and provide the best patient care possible. High job satisfaction also reduces turnover rates, saving you money on recruiting and training new staff. Plus, a positive work environment enhances teamwork and overall organizational culture, contributing to the long-term success of your healthcare organization. 

Developing Effective Wellness Programs 

If you want to positively impact your employee’s well-being, you need to develop a wellness program they actually want to be a part of. Creating a wellness program that resonates with your staff involves understanding their needs and preferences. What challenges is your team facing that might be unique to your healthcare organization, community, or staff makeup? What activities appeal to them in and outside of work? Ask your team for input and craft a program that will resonate with your staff.  

Here are some key components to consider: 

• Physical Health Initiatives: Encourage regular exercise by offering gym memberships or on-site fitness classes. Promote healthy eating by providing nutritious meal options in the cafeteria, and take into consideration the allergies and dietary restrictions of your staff when possible. 

• Mental Health Support: Provide access to counseling services and stress management workshops. Implement mindfulness and relaxation programs can also help employees manage their mental health. 

• Flexible Work Schedules: Allow for flexible working hours where possible. This can help employees manage their work-life balance better, reducing stress and burnout. 

• Recognition and Rewards: Regularly recognize and reward employees for their hard work and dedication. This can boost morale and job satisfaction. 

Looking for more ideas on creating wellness programs? Follow us on socials for Wellness Wednesdays every month! Check out our LinkedIn, X, and Facebook. 

Managing Workload for Your Employees 

One of the most significant contributors to employee stress in healthcare is an overwhelming workload. Managing this effectively is crucial for employee well-being. Take a strategic look at your organizational chart and job descriptions. Have any of your long-term employees experienced job bloat? Are there areas in your workflows that are bogging down your employees or clogging up processes? These could create unmanageable workloads and add to burnout. Here are some strategies to improve employee workloads: 

• Efficient Staffing: Ensure that staffing levels are adequate to meet patient needs without overburdening employees. Research best practices for providers and administrators in your field and adjust your staffing levels accordingly. 

• Task Delegation: Delegate tasks appropriately to ensure that workloads are evenly distributed and manageable. Struggling to delegate? Check out this blog for tips! 

• Regular Breaks: Encourage employees to take regular breaks to rest and recharge throughout the day. Pausing and resetting regularly can prevent burnout and maintain high performance levels. 

RCM and Employee Wellness 

What does your revenue cycle have to do with employee wellness? If your organization wants to grow, bring on new talented staff, improve your technology and expand your programs, you need revenue. But, relying solely on an internal team for billing can stretch them thin, leading to errors, delays, and missed revenue opportunities. Outsourcing your revenue cycle management or even just your AR Cleanup means your billing will be handled by dedicated experts, allowing your internal team to focus on patient care. This strategic move can boost your bottom line, but also enhance your overall efficiency and staff well-being. Here’s how: 

• Reduced Administrative Burden: Outsourcing your RCM allows healthcare professionals to focus on patient care rather than administrative tasks. This reduces stress and improves their overall job satisfaction, which means better employee retention and a stronger team. 

• Increased Efficiency: Professional RCM services often have more efficient processes in place, leading to faster and more accurate billing and collections. After all, these are dedicated professionals that only handle billing, all day, every day. Having these experts working for your organization will improve the financial health of your organization and reduce the stress on your employees. 

• Improved Work-Life Balance: With the administrative burden reduced, your employees can enjoy a better work-life balance. This leads to lower burnout rates and higher overall well-being. 

Taking care of your team’s well-being is a must for any successful healthcare organization. When you focus on wellness programs and manageable workloads, you are not just making your employees happier — you are also boosting job satisfaction, retention, and overall performance, which helps your healthcare organization provide top notch care to your community. Plus, outsourcing your revenue cycle management can take a huge load off your staff, letting them focus on what really matters: patient care. Creating a happy, healthy workforce will also create a happy, healthy community.  

Collecting patient payments is a challenge for most of the healthcare organizations we talk to. Often we find that their financial policies, initially built to make patient payment collection possible, are actually keeping patients from making payments on their balances. These financial policies are usually built with a one-size-fits-all mentality, and that approach fails to address the diverse needs of a diverse patient population. 

Even though all your patients may share similar traits, they are not part of a homogenous group. Creating a patient financial policy that responds to the distinct groups in your patient population is a great place to start improving your patient payments. 

Who are your Patients Financially? 

What’s the best way to segment your diverse patient population? 

We recommend starting with ability to pay. Several distinct groups emerge when you examine your patient population through this lens, and each group has different needs with regard to financial policy. By considering these groups, you can create a workable patient financialy policy that addresses the unique needs of your patients when it comes to collecting payment. 

Creating policies that adapt to all groups will also help avoid confusing exceptions to rules and create a process that is both clear to staff and fair to patients. 

The Easy Pay Group 

The first group to examine is the Easy Pay Group. These patients have the ability and desire to pay. All they really need is simple access to your organization’s preferred method of payment and they will make their payments. 

Removing all barriers to making payments and providing simple, easily accessibly ways to pay will increase payments collected from this group. 

How to make patient payments easier for this group: Make use of balance resolution tools 

• Place a payment button on your website 

• Offer automated payment plan options 

• Be able to accept as many different payment types as possible 

The Challenged Pay Group 

The second group is the Challenged Pay Group. These patients want to make their payments, but they have limited means to pay and making their payments can be challenging. While these patients will benefit from balance resolution tools, they are often not enough to ensure prompt payment. This group will usually complete their payments before the intervention of a third party collection agency, though some patients might be in serious financial distress. 

How to make patient payments easier for this group: Intervene early 

• Ensure balance resolution tools are accessible 

• Have interventions and payment options available at time of service 

• Be willing to coax and nudge with compassion 

The Inability to Pay Group 

This group simply does not have the means to pay for most or all of their portion of healthcare costs. Leading with compassion is the key to success for collecting patient payments from this group. Whether patients are in the group through situations beyond their control or through their own actions, consideration and a clear policy lead to the highest success. 

How to make patient payments easier for thie group” Lead with compassion and have a well developed financial plan 

• Address the group at the beginning of care rather than months or years post treatment 

• Be kind and considerate when discussing financials 

• Develop clear policies outlining discounted rates for this group 

The Refuse to Pay Group 

The final group is hopefully the smallest. Typically, those that fall into the Refusal to Pay Group fall into one of two scenarios. Some are manipulative, and those might respond to third party collections, especially if the bill is large. Others in the group might perceive that they have been mistreated during their care, and these patients require careful consideration because heavy handed collection techniques could cause additional complaints. 

How to make patient payments easier for this group: Engage a collection agency and attorneys if needed 

• Engage a collection agency 

• Run credit scores to determine cost effective actions 

• Consult with a healthcare attorney if collection agency methods fail 

Understanding and segmenting your patient population’s financial identity is crucial for improving payment collections at your organization. By moving away from a one-size-fits-all policy and instead leading with empathy and tailoring your approach to the distinct financial needs of your patients, you can create a more effective and compassionate payment collection process. Looking for guidance on processes and payment types? Download our free guide “Making Patient Payments Easier” to learn more!