How Can a Revenue Cycle Management Assessment Benefit Your Behavioral Health Organization?

You are well aware that revenue cycle management (RCM) is essential for the continued success of your behavioral health organization. But how can you be certain that your team is functioning with maximum effectiveness at every step throughout this complicated process?

One easy way to put your mind at ease is to schedule an RCM assessment.

Why Should You Schedule a Revenue Cycle Management Assessment?

According to Cynthia Sikina, Vice President of Financial Services at SimiTree Behavioral Health, the goal of an RCM assessment is to identify any processes and system functionality that may be preventing your behavioral health team from achieving sustained excellence in revenue cycle management.

However, this does not mean that the sole purpose of an RCM assessment is to find shortcomings. Additional benefits of an RCM assessment include:

  • Confirming that your behavioral health team understands every step in the healthcare revenue cycle, including how people and departments contribute to this process
  • Identifying what your team is doing well, and verifying that these best practices are implemented consistently throughout your behavioral health organization
  • Ensuring that everyone who plays a role in revenue cycle management feels that their voice has been heard and their contributions are valued

“RCM assessments help behavioral health organizations answer three important questions,” Sikina said. “What is working well? What could work better? And what is broken and needs to be fixed?”

What Happens During an RCM Assessment?

When conducted by SimiTree Behavioral Health experts, an RCM assessment for a behavioral health organization occurs in the following three phases:

Phase 1: Planning & Kickoff

Once a contract for an RCM assessment has been signed, SimiTree Behavioral Health creates a client questionnaire to gather information about the processes and personnel that are involved in the behavioral health organization’s revenue cycle management efforts.

After SimiTree Behavioral Health has received and reviewed the completed questionnaire from the client, a kickoff videoconference is scheduled with everyone who will be involved in the RCM assessment.

During this call, the leader of the behavioral health organization will discuss the purpose for the RCM assessment and introduce the SimiTree Behavioral Health team. SimiTree’s representatives will explain the RCM assessment process and answer any initial questions.

An important element of this videoconference, Sikina explained, is to emphasize that the goal of the RCM assessment isn’t simply to assign blame. Instead, she said, the RCM assessment team’s role is to help the behavioral health organization ensure that they’ve put the proper processes in place and that all personnel have the training, tools, and support they need to do their jobs.

“We want everyone to understand why we’re there and what we’re doing,” Sikina said. “We can highlight what they’re doing right and show them what they could be doing better.”

Phase 2: Discovery, Analysis, and RCM Recommendations

Phase two typically occurs over a tightly scheduled three days, during which the RCM assessment team meets with all personnel — including both department leaders and frontline staff — whose efforts contribute to the revenue cycle. Examples of staff who are usually interviewed include those in the following roles:

  • Executive leadership
  • Accounting
  • Billing
  • Cash posting
  • Coding
  • Credentialing
  • Payer contracting
  • Pre-visit scheduling/call center
  • Front desk/intake
  • Quality/compliance

Ideally, these interviews all take place on-site. However, if a behavioral health organization has multiple locations that are geographically dispersed, some discussions may need to take place via videoconference.

During these interviews, the SimiTree Behavioral Health team doesn’t only focus on “big picture” topics such as the organization’s structure and policies. They also devote considerable time to the details of each person’s role, including whether they have the support they need to do their best work.

“Is the EHR set up properly, and is everyone using it correctly?” Sikina asked, providing examples of the breadth and depth of these discussions. “Are the schedulers matching patients with appropriately credentialed professionals so [that] their insurer will pay for the service? Do the front desk staff have access to a scanner that can copy both the front and back of patients’ driver’s licenses and insurance cards?”

Throughout the RCM assessment process, they encourage those who are being interviewed to identify challenges they regularly encounter and share their suggestions for how their workplace could function more effectively.

“We talk about the good, the bad, and the ugly,” Sikina said. “We want to be sure that every employee understands the role they play in the revenue cycle. We also want them to know that their voice is being heard.”

Phase 3: Reporting

Within six to eight weeks after execution of the contract, the SimiTree Behavioral Health team will give a full presentation to the behavioral health organization’s executive team and an abbreviated presentation to the entire staff.

They will also provide the behavioral health organization with the following information:

  • Written report of key findings and recommendations
  • List of every employee who was interviewed
  • Revenue cycle recommendations grid
  • Results of data analysis

The revenue cycle management assessment team from SimiTree Behavioral Health will organize their recommendations into categories such as:

  • Process change
  • EHR setup change
  • Organizational change
  • Reporting recommendation
  • Training recommendation

The RCM assessment team will also prioritize these recommendations in terms of their potential impact on the behavioral health organization’s revenue cycle, as well as the estimated time and effort that will be required for implementation.

“We find that the presentation to all RCM assessment participants generates a lot of excitement,” Sikina said. “People can see evidence that they were heard. They can also see that their executive leadership is willing to make the necessary investment to make sure that everyone has what they need to do their job efficiently and effectively.”

Learn More About RCM Assessments

You understand the critical importance of revenue cycle management for your behavioral health organization’s continued success. By scheduling an RCM assessment, you can:

  • Confirm that every step in your behavioral health organization’s revenue cycle is clearly understood
  • Identify and implement best practices consistently to ensure that you are billing and collecting the correct amount for all services provided on a timely basis
  • Ensure that every team member feels valued

Contact SimiTree Behavioral Health today to learn more about how our RCM assessments can elevate your behavioral health organization's revenue cycle management to new heights. Don't wait! Take steps to ensure your organization has the best chance of reaching revenue cycle excellence — a key contributor to the financial health of your organization.