As provider organizations and healthcare management companies start to adjust their new working methods while coming out of a pandemic, revenue cycle billing trends also come to new light in 2022. There have been several instances of federal regulation updates starting from the beginning of the pandemic in early 2020. These temporary regulations followed their way through 2021. But with increasing vaccination numbers across the nation, the government has relaxed several rules regarding revenue cycle billing. The private insurance companies are also editing some of their temporary rules and deleting the rest of them.

To put it shortly, 2022 is an important year for the revenue cycle billing leaders all over the USA. The healthcare systems have suffered from poor finances since the pandemic. They have also suffered from other issues like lack of remote working models, updated workflows, and staff shortages. The year 2022 shows a way forward for these healthcare systems to retrieve their finances without hindering the patient experience. Is hiring the way out to manage staff shortages, or can automation help? Know these key revenue cycle billing trends for 2022 to find out.

Automated Coding Systems

  • According to a report by Kaufman Hall, the hospital operating margins have been predicted to be 80% below the pre-pandemic phase in 2021. These reports have given increased impetus to adopt automation technology to eliminate the clerical and manual errors in daily revenue cycle billing functions.
  • Most healthcare systems are moving towards or have already adopted software solutions to prevent coding errors in revenue cycle management. The coding automation systems ensure that the healthcare organizations get the most out of their claim submission, which will ultimately improve their business outcomes.
  • The medical coding automation systems combine technologies like the OCR, natural language processing (NLP), Universal Medical Language Systems (UMLS), and virtual scribing to produce the most effective results. Some of the more advanced systems exhibit functions to also manage discharges not fully coded (DNFC). All these efforts combined ensure decreased revenue leakage with decreasing cost to collect.

Clearing House Modernization

  • Data analytics and data interchange methodologies will find their way to being one of the most critical parameters of revenue cycle billing in 2022. Healthcare management teams are seeking more sophisticated data tools to capture and analyze the data points in a daily workflow.
  • Revenue cycle leaders believe that with clearing house modernization techniques, the data flow and analysis divisions will be more efficient in the management process. These modernization techniques will benefit the issues of prior authorization and patient eligibility verification, which have lacked the scope of improvement in the past.
  • Lack of proper information exchange protocol might have been the reason for the slow development of clearinghouse modernization in the past few years. More evolved API-driven information exchange systems available in 2022 will help the revenue cycle billing teams to resolve these issues.

Transparent Patient-Provider Relationship

  • A deficit of information regarding healthcare finances between the patients and provider organizations leads to stalled payments and thus occurs to be a hindrance in the cash flow. Patient experience is of utmost importance to healthcare organizations in 2022.
  • The patients demand to know what kind of services they can expect from a particular healthcare system of their choice. Moreover, they need to know a complete break-up of insurance-covered services and their responsibility for out-of-pocket expenditures. Most revenue cycle billing resources suggest that discussing the different aspects of the billing with the patient beforehand gives them a better understanding of the entire process.
  • The patients also need to know the financial services offered by the healthcare organization to make an informed decision. As the conversations around financial responsibility become more transparent in the system, the better the patient experiences become. These steps ensure that your patient loyalty curve stays upwards and your patient collections become easier, thus improving your revenue integrity. In 2022, healthcare organizations are focusing more on training their staff to achieve these goals.

Front-end Services Integration

  • Denial management and rejection analytics speak a lot about the efficiency of the revenue cycle billing process in place. However, it is more convenient to have a methodical approach to assess the recurring issues, especially if you want to achieve better workflow management.
  • Revenue cycle leaders believe that the majority of issues hindering the revenue cycle growth lie in the front-end services of the healthcare organization. Front-end services include processes like prior authorization, patient eligibility verification, and patient registration procedures. A smooth transition to each of these phases can bring more clarity to the staff and thus help in analyzing or avoiding any claim denial.
  • In some cases, the problems still prevail even though the healthcare organization already has several automation systems to take care of the issues. Experts believe it is due to the lack of integration of separate islands of workflows. Make the most of the automation systems in place through proper integration.

Performance Analytics

  • Throughout a typical day in a working healthcare organization, the various departments of the organization come across and record several data points related to patient experience, financial management, and revenue cycle billing performance.
  • Combining and analyzing these separate data points are mandatory to properly monitor the performance metrics of the organization. An efficient revenue cycle management department will make sure that they establish tangible RCM key performance indicators to measure the change in their performance.
  • Not all KPIs are applicable to all kinds of healthcare organizations. They will depend on various factors like the scale of the organization, the specialties present, and the medical billing system in place. If you are struggling with staff shortages in your organization, you could get in touch with a professional RCM company to take care of these reports for you. With the increased tightening of profit margins in the healthcare industry, the management system should leave no place for error.

We hope this article helped you understand the top revenue cycle billing trends that will dominate the American healthcare industry in 2022. Please connect with us in the comment section below in case of any queries. Subscribe to our blog for regular articles on the medical billing industry. Follow us on Facebook, Instagram, Twitter, and LinkedIn for more.