Is your SNF leaving money on the table? Learn about three ways to close RCM gaps and maximize your cash flow in our newest blog.
Last month, Quality Healthcare Resources hosted a webinar with McKnight's Long-term Care News on how skilled nursing facilities can increase their cash flow through strategic revenue cycle management. QHCR’s Director of A/R, Chaim Cohen, outlined key challenges skilled nursing communities face today, how strategic RCM can unlock resources to solve those challenges, and actionable ways to prevent leaving money on the table.
Here are three of the biggest takeaways to improve your bottom line:
#1: Track patient coverage from admission to discharge
Before you even provide care or submit a claim, you’re impacting your cash flow. That’s why tracking patient coverage is one of the most important parts of your revenue cycle management. You need to know, whether it’s day one or day 100, that every patient in your facility has a payer or a plan to get a payer. You can’t get paid if there’s no one to bill.
Patient tracking is especially important right now as communities struggle with low census and admit more Medicaid-pending patients. While admitting lower-coverage individuals is a business decision that every facility must make, it’s no use having a full bed if you won’t be reimbursed for care.
Here are a few easy ways to make sure you’re considering and tracking patient coverage:
- Use Patient Intake Questions to mitigate admitting riskier Medicaid-pending patients. Simple questions that confirm a patient’s coverage or verify their citizenship can help you prepare for different payment scenarios.
- Plan for long-term coverage during your UR meetings and start the appropriate paperwork and applications as soon as you know a patient’s stay will be long-term.
- Create a simple system to track coverage, pending cases, and due dates. This could be a simple Excel spreadsheet or a more robust tool. The goal is to make sure all your patient coverage information lives in one place.
#2: Discuss payment with residents before billing
While most skilled nursing communities include a financial intake meeting as part of their patient onboarding process, it’s important to make it a consistent and thorough part of onboarding so patients aren’t confused or frustrated when they receive their first bill. Some facilities avoid financial discussions because they worry about appearing opportunistic. Others don’t have a clear agenda for the financial intake meeting. However, educating your residents and their families about the cost of care increases your chance of being reimbursed for care.
Here are some easy tips to run an organized and well-managed financial intake meeting:
- Build the financial intake meeting into the facility visit. The financial intake meeting shouldn’t be an afterthought, so treat it as extension of your facility tour.
- Walk through all patient benefits, coverage, relevant care, and payment scenarios during the meeting. Taking the time to clearly educate your patients and their families about payment will reduce confusion or surprise when they receive a bill. It also establishes you as a valuable resource and partner which is part of a great care experience.
- Share copies of all documents and include an FAQ so patients and family members can reference what you discussed and follow-up with questions. Use clear and easy-to-understand language. Skip the acronyms and jargon and define key terms.
#3: Make claims management a continuous (even daily!) part of your RCM strategy
Time is your enemy when you’re trying to get reimbursed for care. Continuous claims management means consistently working claims and always having a next step to move the claim toward payment. It can be tempting to put off managing claims to once a week or even less frequently, but you run the risk of mounting aging and losing track of where you are in the claims process.
Here are a few ways to make claims management less stressful and more effective:
- Use posting payment as an early tool to identify issues and start working a claim. Posting payment is the first time you can see what you’re being paid on a claim and where money might be missing.
- Get a reason for every denial. You can’t fix a problem if you don’t know what it is and asking the insurance company to resubmit the claim isn’t effective if you haven’t identified the root problem.
- Create a centralized tool to track your claims and to set up alerts and reminders. Similar to patient tracking, you want all your claims information to live in the same place, so you are operating off the most up-to-date and organized information.
Why it matters: Every dollar counts
Earlier in the COVID-19 pandemic, an AHCA/NCAL survey found that 55% of nursing homes were operating at a loss and 89% of nursing homes were operating with a profit margin of 3% or less. Despite government intervention and financial assistance, communities across the country are still struggling to keep their doors open.
Systematic and strategic revenue cycle management is critical to ensure you aren’t leaving precious dollars on the table. Luckily, taking simple and consistent steps from patient intake through to claims management can have a big impact on your bottom line!
And if you still aren’t sure whereto start? Quality Healthcare Resources offers a complementary A/R Assessment. Contact us here to get started.