Sunday, February 28, 2010

Solving the Revenue Cycle

By Mark Brousseau

Banks are well positioned to help “solve” the healthcare revenue cycle, thanks to the keystone revenue cycle data that flows through banks every day, Benchmark Revenue Management CEO Tyson McDowell said at the Medical Banking Project Boot Camp in Atlanta this afternoon.

“Banks can solve operational improvement issues for hospitals, while solving transparency and risk management issues for themselves,” McDowell told attendees. He said banks should “grow-up” their healthcare revenue cycle solutions and extend into denial management, denial avoidance, and services that back up their healthcare customers’ revenue cycle workers with “on-demand” talent.

Today, many banks offer lockbox services, patient payment solutions and extended lockbox services.

“The revenue cycle improvement market is exploding due to permanent financial pressures,” noted McDowell. “While the official definition of the revenue cycle is all of the administrative processes related to collecting all fees owed for services to patients, a more practical definition would be: a near futile attempt to collect all the monies owed in a world with thousands of moving parts.”

“A hospital really has no idea how much money it’s going to get paid,” McDowell said. “Hospitals and, to a lesser extent individual doctors, are getting it from all sides. Healthcare providers need to protect themselves. And denial and payment data is the keystone for solving the revenue cycle.”

Banks have unique access to this information, McDowell said, and they offer value-added services like lockbox. “Banks are in a position to provide new services for healthcare. And it comes from the data. The hospital needs someone to tell them why they need to spend money on an improvement.”

McDowell concluded that banks are starting to move in the direction of new healthcare services.

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