Improve Physician Group Reimbursement With a Physician Revenue Cycle Liaison

Healthcare leaders identified the following as their top business priorities for the year:

Many organizations feel unprepared, however, to address these priorities for several reasons:

  1. Competing internal priorities
  2. Difficulty integrating systems, personnel or practices
  3. Evolving regulations make requirements unclear; Complex organization structure impeded broad change
  4. Lack of clear strategy

The unique challenges facing physician groups can exacerbate this feeling of unpreparedness:

  • Large numbers of stakeholders
  • Varying department/service line goals and strategies
  • Often de-centralized front-end processes (including registration, referrals and point of service collections)

What is a Physician Revenue Cycle Liaison?

A physician revenue cycle (PRC) liaison can help address the issues medical groups face and engage disparate stakeholders across the organization around revenue cycle improvement.

The liaison is typically an individual in a manager role with a background in physician coding or billing and a strong understanding of technical applications. They help build trust by facilitating proactive conversation through publishing meaningful reports with metrics providers can actually impact.

The PRC liaison serves as the connection point between the front line, business office and department leadership teams. This dedicated resource:

  • Proactively identifies, designs and implements revenue cycle performance improvement initiatives
  • Regularly publishes metric-driven scorecards
  • Holds recurring discussions with relevant stakeholders to keep them in close collaboration

With a PRC liaison in place, stakeholders understand who to contact with their questions and concerns and can begin to reduce avoidable denials and write-offs. Without this intermediary role, keeping the potentially large number of stakeholders educated on the latest revenue cycle data and initiatives can be difficult. For example, a liaison can help physicians determine what services may not be covered and how their documentation impacts coding practices.

Physician Revenue Cycle Challenges

Denial prevention is a struggle in all healthcare settings, but this is especially true in outpatient settings. According to a Huron survey, common struggles for organizations without a liaison include:

Benefits of a Physician Revenue Cycle Liaison

In our recent survey, clients that had implemented a liaison identified their biggest areas of improvement:

Once these organizations implemented a liaison, their challenges shifted to more strategic initiatives focused on advancing performance:

How to Implement a Physician Revenue Cycle Liaison

Best practices for implementing a PRC liaison include the following steps:

Gain an understanding of the business need by assessing your organization’s provider and operational leadership engagement in revenue cycle performance.
Partner with human resources to determine the requirements of the position and where the position falls within the organization.
Hold design meetings with clinical, operational, technical and revenue cycle leadership to establish goals and priorities, communication structures and role responsibilities.
Create an accountability structure for liaisons to report out on key initiatives and metric improvement to health system executives.
Develop system, department, specialty and provider-level reporting to measure revenue cycle performance and progress toward established goals.
Pilot the liaison program with a select group of specialties before launching system-wide.

Key Takeaways

Driving revenue enhancement and cost containment across a physician group can be a daunting task. To help everyone prioritize revenue cycle improvement, organizations should:

Think differently.

Look for new ways to encourage collaboration between physicians, the business office and the front line, and dedicate time to improving physician revenue cycle performance.

Plan differently.

Bring clinical, operational, technical and revenue cycle leadership together to design a dedicated role for enabling the organization to develop and measure new physician revenue cycle initiatives.

Act differently.

Gather meaningful metrics and feedback from physician and department leadership to continue to refine your revenue enhancement strategies.