As more payers adopt value-based care models and more patients self-pay for their behavioral health treatment, the patient experience becomes more relevant to providers. Instead of making money through reimbursements for additional interventions, healthcare organizations are starting to see the value in lower readmission and relapse rates. This is how patient success can improve revenue cycle management (RCM).

Sunwave Health is an integrated software for behavioral health providers. By connecting all aspects of the patient journey, you can streamline workflows and improve patient outcomes. Find out how we can help you operate from admissions to revenue cycle management by calling 561.576.6037.

Understanding Revenue Cycle Management

Revenue cycle management encompasses the entire process of handling claims, processing payments, and generating revenue. Key components include billing, collections, coding, and claim processing. Behavioral health providers, particularly those dealing with substance use disorders, face unique challenges in managing their revenue cycles due to the complexity of treatment plans, varying insurance coverages, and regulatory compliance requirements.

Insurance verification is a crucial first step in the revenue cycle management process. This involves checking a patient’s insurance coverage and benefits before treatment begins to ensure accurate billing, reduce claim denials, and avoid payment delays. Reducing denials, appeals, and rejections is crucial for maintaining a healthy revenue cycle.

The Role of Patient Success in RCM

Patient success in behavioral health refers to the effective treatment and long-term recovery of patients. High patient success rates reduce readmissions, lower treatment costs, and enhance overall patient satisfaction. In value-based care models, where reimbursement is tied to patient outcomes, successful patient treatment directly impacts financial performance. Improved patient success leads to better compliance, fewer denied claims, and a more streamlined revenue cycle.

Benefits of Patient Success on Revenue Cycle

When patients make progress in their treatment and experience positive outcomes, providers can see several benefits, including:

• Enhanced revenue – Successful patient outcomes lead to increased patient retention and satisfaction, which translates into steady revenue streams.
• Administrative efficiency – With fewer claim denials and reduced administrative burdens, staff can focus more on patient care rather than paperwork.
• Financial performance – Efficient management of reimbursements and payments improves overall financial health, making it easier to invest in further patient care improvements.
• Competitive advantage – In a market driven by patient satisfaction and outcomes, high patient success rates can give providers a competitive edge.

Improving the revenue cycle in a value-based model requires a holistic approach that prioritizes patient success. By focusing on providing high-quality care and achieving positive outcomes, providers can improve their RCM and thrive in the evolving landscape of behavioral healthcare.

How Sunwave Health Can Help

Sunwave Health provides a comprehensive solution tailored specifically for behavioral health providers. Our platform offers real-time data access and unifies all aspects of operations under one roof, allowing for seamless integration and optimized results.

• Unified platform – Sunwave Health’s integrated system combines customer relationship management (CRM), electronic medical records (EMRs), RCM, and alumni support, ensuring a holistic approach to patient care and revenue management.
• Real-time data access – The platform provides instant access to critical data for authorized users, facilitating better decision-making and efficient financial management.
• Compliance and security – Ensuring compliance with HIPAA and other regulations, Sunwave Health’s solutions offer secure and reliable information management.
• Telehealth solutions – Telehealth services provide flexibility and convenience, helping to maintain high levels of patient engagement and success.

When your operations are integrated and streamlined, your organization can focus on providing the best possible care to patients while also improving financial performance.

Contact Sunwave Health for a Demo

If you’re ready to see how Sunwave Health can help improve your revenue cycle management and patient success, schedule a demo today. Our team will walk you through our platform and discuss how our solutions can benefit your organization. Don’t let the evolving landscape of behavioral healthcare impact your revenue cycle—let Sunwave Health guide you toward success.

Call 561.576.6037 or contact us online and take the first step toward a better revenue cycle.