Physician Revenue Cycle: A Key to Successful Integration

By Kelvin Drawdy, Director, JHD Healthcare Partners

As hospitals and health systems take steps to develop sustainable relationships with physicians, they are increasing physician practice acquisition and physician employment.  Effectively integrating the revenue cycle should be a top priority because it not only affects the financial performance of the health system, but may also affect the physicians’ compensation, and their satisfaction.

The Healthcare Financial Management Association defines revenue cycle as: “All administrative and clinical functions that contribute to the capture, management, and collection of patient revenue.” In other words, from the point of first patient contact to final payment and settlement of the claim. Each of the following functions must be performed for the revenue cycle to be effective – and must be prioritized as part of the integration of new physicians and practices.

  • Pre-Visit/Pre-Service Processes
  • Front-End Process at Time of Service
  • Encounter – Patient Services
  • Billing
  • Third Party Claims
  • Payment Processing
  • Patient Collections

There are challenges to successfully integrating the revenue cycle functions of the newly acquired practice into the health system and gaining the trust of the physician that the revenue cycle is working.   Efficiencies can be achieved working in a large health system, but if not executed well there is a risk of losing the physician’s trust and lowering the patient’s satisfaction.

If the physician revenue cycle isn’t meeting expectations, this could be an indicator the health system has issues integrating the physician revenue cycle or that it is not effectively prioritized or managed as part of the overall system.  Timely recognition and resolution of these issues will keep physicians and patients happy, and improve the health system’s financial results.

Let’s discuss how your health system is managing the challenges of your physician revenue cycle.

Kelvin Drawdy is a director with JHD Healthcare Partners.  For a complimentary assessment, please visit JHDHealthcarePartners.com.

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