Kristy Smith, Director at Bridge Revenue Solutions, shared on LinkedIn:
“Let’s talk about something I’ve seen cause some pretty significant revenue breakdowns.
Communication. Or more importantly, the lack of it.
Here’s a scenario I’ve seen play out. The patient comes in for a consult. The doctor puts in the orders. The authorization team does their job, gets the authorization approved, and passes it along to billing.
In the authorization person’s mind, their job is done. They got the approval. The patient is good to go.
But somewhere along the way, the doctor changes the orders. Or the patient changes insurance. And nobody communicates that change back to the authorization team. Now what?
You have an authorization that may no longer match the treatment being delivered. You could have claims going out under the wrong insurance or treatment being delivered without the correct authorization.
And nobody necessarily did anything wrong. They did the job they were assigned to do. The problem is that nobody was communicating across departments.
This is exactly why at Bridge Revenue Solutions, we implement daily or weekly touch-base meetings. We want our teams talking to each other. We want to know when orders change, when insurance changes, when something needs to be revisited, and who is responsible for following up.
I’ve said it before, and I’ll say it again: Revenue cycle is not a bunch of individual departments doing their own thing. Every single piece affects the next one.
You cannot just obtain an authorization, check a box, and assume everything is good from that point forward. The process has to continue. The communication has to continue.
Because by the time that breakdown shows up in your AR, you’ve already missed the opportunity to prevent it.
Sometimes it’s not about working harder. It’s about getting everyone in the same conversation.
And that can make a HUGE difference.”
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