How do you measure and demonstrate the value of payment posting and reconciliation to the organization?
Payment posting and reconciliation are essential processes in revenue cycle management (RCM) that ensure accurate and timely recording of payments, adjustments, and denials from various sources. However, these tasks can also be time-consuming, error-prone, and complex, especially with multiple payers, systems, and formats involved. How do you measure and demonstrate the value of payment posting and reconciliation to the organization? Here are some tips and best practices to help you optimize and communicate the impact of these functions on your RCM performance and goals.
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Stephen Della NoceHealthcare Transaction Advisory Services | Financial Due Diligence | Private equity CFO experience
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Dr.Syed Shumail AzeemMedical Insurance Lead @ SABIC | Cert CII®, IFCE, Revenue Cycle Management
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To measure and demonstrate the value of payment posting and reconciliation, the first step is to define the key metrics and benchmarks that reflect the quality, efficiency, and effectiveness of these processes. Common metrics include payment posting accuracy, turnaround time, variance, reconciliation rate, and discrepancy. You can use industry standards, historical data, or organizational targets to set your benchmarks and compare your performance against them. Additionally, segmenting your metrics by payer, service, location, or other relevant factors can help you identify trends, issues, or opportunities for improvement.
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One thing us quite helpful and result oriented is to update the aging report post Reconciliation phases which will help track the collection and payment respectively.
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Measure the accuracy of payment posting by comparing the posted amounts to the actual payments received. Low error rates indicate efficient and reliable payment posting processes.
The next step to measure and demonstrate the value of payment posting and reconciliation is to automate and streamline your workflows to reduce manual work, errors, delays, and costs. Leveraging technology and tools such as electronic remittance advice (ERA) and electronic funds transfer (EFT) can help eliminate the need for paper checks and statements, data entry, and scanning. Payment posting rules and exceptions can also be applied to different types of payments, adjustments, and denials to standardize the process and handle complex scenarios. Finally, reconciliation reports and dashboards display metrics, status, and discrepancies in real-time across different levels of detail to help monitor and manage the process.
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Without a robust system in place, organizations risk losing revenue, encountering compliance issues, and compromising overall financial health. Many are left in the dark, unable to quantify the impact of payment discrepancies on their bottom line. We suggest creating a comprehensive Payment Posting and Reconciliation strategy. At RND Softech, by implementing automated systems and leveraging advanced analytics, we streamlined the billing processes, identified discrepancies in real-time and ensured accurate revenue capture. However, it's crucial to avoid common pitfalls such as overlooking data accuracy, underestimating the power of automation and neglecting staff training.
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The basic integration tool specifically in healthcare Industry capturing all sorts of metric,fields,options etc is best with utmost options.i.e HIS hospital information system.
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Track the time it takes to post payments from the time they are received. Timely posting ensures that revenue is recorded promptly and accurately, contributing to improved cash flow and financial performance.
The final step to measure and demonstrate the value of payment posting and reconciliation is to communicate and collaborate with your stakeholders, such as management, staff, payers, and patients. Through your metrics, workflows, and reports, you can educate and inform your stakeholders about the importance of payment posting and reconciliation; solicit and provide feedback on roles, responsibilities, and expectations; and align and coordinate activities. Additionally, these metrics, workflows, and reports can highlight achievements, best practices, areas for improvement, address questions or concerns that may arise, ensure compliance with processes and policies, schedule or prioritize payments or adjustments, verify or resolve denials, and escalate issues as needed.
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Regarding the value of payment posting, in a transaction situation where the organization's revenue will be backtested using cash collections data from the EMR, if payments don't reconcile to financial statements/bank statements, uncertainty is created and value is lost. Operationally, if payments aren't accurate, this results in a few problems: sending patients incorrect bills, not having a clear picture of what AR is open, not having a clear picture of revenue cycle performance and where there is opportunity to find more cash.
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Ofcourse the communication should ne at regular intervals with the stake holder whether the payers or the recipient t,and in some instances the brokers,all these will effect positively in avoiding posting and payment delays.
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Monitor the reconciliation rates between posted payments and accounts receivable records. High reconciliation rates demonstrate thoroughness and accuracy in the reconciliation process, reducing the risk of revenue leakage or discrepancies.
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RCM teams could closely monitor billing operations, uncover inconsistencies in real-time and assure proper revenue capture by deploying automated technologies and leveraging advanced analytics. However, common errors must be avoided, such as overlooking data accuracy, underestimating the power of automation or ignoring staff training.
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Well a better timely Reconciliation process needs a score card depicting the phases and standing of all entities.this is practical approach
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Assess the impact of payment posting and reconciliation on cash flow management. Analyze trends in cash collections, accounts receivable turnover, and days sales outstanding (DSO) to demonstrate how efficient processes contribute to improved cash flow and liquidity.
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Measure the reduction in denials, rejections, and payment discrepancies as a result of accurate and timely payment posting and reconciliation. Lower denial rates indicate improved revenue capture and reduced administrative burden on staff.
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Track the productivity and efficiency of payment posting and reconciliation processes. Measure the number of payments posted per hour or per FTE (full-time equivalent) staff member to assess efficiency gains over time.
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