As more hospitals realize the importance of managing their revenue stream at every level, the need for an effective and efficient Revenue Cycle Management (RCM) team is apparent. Hiring a successful RCM team can be achieved with advanced planning and internal coordination. The goal should be to form a team that will optimize your claims processing, payments, and revenue generation.
Before you begin the hiring process, decide how the team will be structured. How many members does your revenue cycle warrant? Who will lead the team? Most RCM teams have about 6-7 members, with representatives brought in for special issues or projects. By having a plan in place, you will be better-prepared for the hiring process by knowing exactly what spots you want to fill.
At this time, you should also decide what internal staff will help support and lead the team, such as personnel from nursing, internal audit, coding, patient financial services, and patient access. A mixture of representatives from a variety of areas will ensure the most effective a knowledgeable RCM team.
Revenue Cycle Management teams should include individuals with financial and clinical backgrounds, to best understand impact on the hospital. Every member of the team must come with the attitude that they can make a difference in the revenue cycle by performing their job to the best of their ability. Each team member should see the group as a collaborative effort to increase revenue and decrease errors.
Two of the most important skills you should look for when hiring RCM team members is efficiency and resourcefulness. The answers will not always be obvious so team members must be able to conduct research and make decisions based on their findings. It is also important that team members have some level of aptitude with technology.
While initial training might be costly, it can save a hospital a sizeable amount of money in the future. If one area of your RCM team is not doing the job correctly, it will affect the efficiency and success of the entire team. Errors in coding or data entry, or not understanding how the job affects the revenue stream can result in a decrease in profitability. Therefore, it is important that each team member is trained not only in their own position, but in how the group functions as a whole.
The RCM team should ensure that all departments involved in this process are properly trained and knowledgeable about their role in the bigger financial picture. For example, those responsible for capturing patient data correctly need to know how to properly capture information on the front end so the data can be successfully billed for on the back end.
Communication among all members of the team is key to improving your revenue cycle. Team members must attend all meetings to review the financial reports and decide what areas need improvement to maximize profitability. Issue and obstacles that arise should be discussed by the group as a whole so every team member feels they are part of the solution. Once the team has been created, it is up to the hospital to determine roles and set expectations so the RCM team can operate successfully.
A hard-working, competent RCM team dedicated to both your organization and your community is critical to the success of your operations and ensuring that accounts are resolved and revenue is generated.