The Intersection of Patient Care: How Clinical Leaders Impact the Financial Health of Healthcare Organizations
July 23, 2023
Clinical leaders are at the intersection of patient care and the financial health of healthcare organizations—they are responsible for both, and the two are inextricably linked. Clinical leaders must understand the complexities of healthcare revenue cycle management (RCM) in order to ensure that their organization’s financial health is secure.
Using a combination of people, processes, and technologies, effective RCM enables healthcare organizations to collect payments, accurately bill patients and insurance companies, and maintain accurate records. Clinical leaders must be knowledgeable about the systems and processes involved in RCM, including:
- Coding and billing accuracy
- Patient insurance eligibility and verification
- Collections
The stakes for clinical leaders are high. Poor RCM practices can lead to non-payment and even financial penalties, as well as bad debt that can put financial strain on an organization. Clinical leaders must be proactive in making sure their organization has the systems and processes in place to ensure accuracy and compliance with federal and state regulations. This involves staying abreast of changing regulations and ensuring staff is properly trained in coding and billing accuracy.
In addition, clinical leaders must ensure that appropriate patient care decisions are being made with the patient’s best interests in mind. This includes making sure medical staff are well-trained in the latest treatments and protocols, and that they understand the financial implications of their decisions. Clinical leaders must also ensure that billing and coding accuracy is being maintained, so that the organization is properly reimbursed for the services it provides.
In conclusion, clinical leaders have the unique opportunity to make a positive impact on both the patient care and the financial health of their organization. By understanding and implementing best practices in RCM, clinical leaders can ensure the organization is financially secure while providing the best possible care to its patients.