RCM 101: Considering the Oft-Forgotten Importance of Follow-Up

RCM 101” is a blog post series that explores the critical tasks and best practices that make up the revenue cycle and offers actionable insight for how to improve its management and overall success.

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In a perfect world, the revenue cycle would end with claims submission and patient billing—ask once for what you’re owed and a timely payment will soon follow. But since we’re stuck with the real world, let me offer this bit of wisdom: never underestimate the importance of follow up. For whatever reason, follow up is usually the first step in the collections process to fly right out the door. And yet it’s the surest way to make sure your center collects.

So what gives? And what are the official game rules for effective follow up?

• First: Follow Up Demands Documentation. 

If it isn’t documented, it didn’t happen, and you’re left with nothing to follow up on. Remember that, and train staff to document every step taken with patients, payers and providers throughout the care and RCM processes. This ensures that when things go awry (and if you’re having to follow up, something has almost certainly gone sideways) there is proof to support your claims and expectations.

• Second: Standardize the Appeals Process.

Denials and appeals are common kinks in the revenue hose, but it’s easier to work things out if you have a standard appeals process in place, including a standard form letter to initiate the effort. If leg work and time expenditure are primary culprits for why people fail at follow up, then a little prep work should position you and your staff for ease of execution later.

• Third: Remember That Time Is Money.

Every aspect of RCM is tied tightly to time management, and once the ball is rolling it’s critical to move fast. Already submitted a claim? Know the average time it takes each payer to submit payment and follow up as soon as they miss the anticipated mark. Collecting additional details for an appeal? Remember that you’re almost certainly working against timely filing requirements and don’t be afraid to nag. Follow up is all about your willingness to be the squeaky wheel—it’s the only way to get what’s yours.

In the world of sales, follow-up is where deals are closed. Similarly, in the world of RCM, follow-up is where the bottom line gets fat and happy.

If your center is struggling to maintain consistent revenue and you suspect follow up habits (or communications in general) are contributing, give us a call to learn more about training and consulting opportunities as well as full-service support options.