CHAPTER 4

Quality Management In The Mid-Cycle

CHAPTER 4

Quality Management In The Mid-Cycle

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KC Navigating the Heart of Healthcare Revenue Mid Cycle RCM_eBook
KC Navigating the Heart of Healthcare Revenue Mid Cycle RCM_eBook
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Provider organizations continue to experience staffing shortages, including in the revenue cycle. Onboarding and training new, inexperienced mid-cycle team members takes time and resources that revenue cycle leaders may not have. When inexperienced individuals come on board, they may inadvertently cause an increase in errors and denials, leading to even more work for teams that are already stretched thin.

Revenue Cycle Impact Related to New, Inexperienced Hires1

Increased denials

Decreased productivity

Poor team morale

Missed revenue cycle opportunities

Providing flexible work environments can help attract and retain experienced mid-cycle professionals.

Even when teams are complete, they may be challenged with growing backlogs, tight deadlines, and time-consuming manual processes. Staff can easily get so bogged down in everyday tasks that they lose sight of the bigger picture. Teams need to understand their role in creating a healthy revenue cycle, which includes understanding how the quality of their work impacts downstream processes and the bottom line.

Provider organizations can elevate the productivity and quality of their mid-cycle teams by adopting the following:
  • Using only credentialed and certified revenue cycle professionals, which could require outsourcing if qualified candidates are in short supply
  • Providing continuing education, including ongoing regulatory and compliance training to keep up with continually changing rules and requirements
  • Implement KPIs to promote accountability, along with incentives for reaching them
KC Navigating the Heart of Healthcare Revenue Mid Cycle RCM_eBook

eBook: Navigating the Heart of Healthcare Revenue

A Comprehensive Guide to the Mid-Cycle and Revenue Maximization

This eBook offers an extensive overview of mid-cycle operations within healthcare provider organizations. It emphasizes the critical importance of coding, clinical documentation integrity, revenue integrity, and health information management. The guide underscores that these processes are not isolated but are integral to both the front-end and back-end of the revenue cycle, affecting overall financial health and compliance.

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