Submitted on Thu, 2014-06-12
By Sarah Maguire

Avoid making false assumptions so that you can generate the sustainable revenue that will help your public health agency thrive in the long run.

Revenue Cycle Management Myths

There are five dangerous assumptions local health departments and community health centers may make about revenue cycle management that can severely hamper the ability to increase revenue. Working to eradicate these long-held and erroneous beliefs will allow public health departments to generate significant sustainable revenue and take advantage of additional funding sources.


Revenue Cycle Management Myth #1: It Doesn’t Work for Public Health Agencies

Regardless of the type of healthcare facility you are, revenue cycle management is a topic you should not ignore. Fundamentally, revenue cycle management is the same for every healthcare facility. It’s the process of making sure you bring in revenue for the services you’re providing, and that the revenue is coming in as close to the time-of-service as possible. There may be differences in how each facility successfully achieves this goal, but getting paid and getting paid fast is always at its heart.

The CDC has a published a number of inspiring stories about local health departments creating sustainable revenue and growing their staff and services. By implementing creative billing programs for existing services, local health departments can collect more revenue and all but eliminate funding issues. We’ve seen revenue cycle management work for public health firsthand too. More than 100 departments have signed up for SMART Health Claims Suite so far this year, and every one of them is seeing dramatically increased revenue.


Revenue Cycle Management Myth #2: Patients Don’t Want to Talk About Billing

Nobody wants to spend money, especially if that person may have very little of it, but that doesn’t mean your patients won’t be open to having a conversation about billing. Conversations about insurance and payments with patients are absolutely vital in public health. Since billing is relatively new to local health departments, patients may walk in expecting to get free service. Patients are often extremely receptive to talking about payment upfront, as long as it’s done with compassion and understanding. Make every attempt to clearly explain your policies and any special payment incentives or rebates they may be eligible to receive.

Talking to patients about billing from the very start will keep their expectations in line with your budgetary realities and allow for every opportunity to collect some type of payment from them. Be sure to read our past article with more tips on how to collect 100% of out-of-pocket expenses from patients.


Revenue Cycle Management Myth #3: Every Patient Has the Same Probability of Paying

Determining the difference between the patients that truly cannot pay and those that can is vital for public health departments. The long-term health of your health center depends on being able to successfully collect payments from those with the means to pay to help subsidize losses from those that cannot. This means collecting as much information as you can from the patient prior to providing them with service.

Train your staff to check to see if they have insurance and to make your payment policies clear from the outset to see if they can meet them. You can then use all of the data collected to determine their likelihood to pay based on their situation and history, and then create customized payment plans to suit their needs.


Revenue Cycle Management Myth #4: It’s Too Costly to Outsource

Contracting with the right third party for revenue cycle management can mean only good things for your bottom line. Revenue cycle management will open up a new revenue source that you previously were not taking advantage of at all. With minimal start up fees and only a small service fee deducted from the new revenue generated, the only impact it will ever have on your bottom line is that you’ll see more revenue. There is no cost or downside. You’re opening up a new funding source to use to improve the health of your community.


Revenue Cycle Management Myth #5: Any Company Can Effectively Support the Needs of Your Public Health Agency

While every healthcare facility can engage in revenue cycle management, not every third party firm may be qualified to successfully oversee the public health revenue cycle. The end goals of revenue cycle management may be the same for local health departments and providers, but the methods necessary to reach those goals can be wildly different given the patient base. Make sure the third party you’re bringing in understands public health and all the challenges it faces to help align your entire organization to meet its strategic goals.


Using our SMART Health Claims Management solutions helps local health departments and community health centers generate 35-70% more sustainable revenue with minimal start up fees. Get a free healthcare revenue performance evaluation today to learn more.

Sarah MaguireAbout the Author

Working in the SMART Health Claims Division, Sarah Maguire utilizes her public health background to address many of the issues local health departments face every day. She helps lead efforts to mobilize communities around important health issues and link people to health services. You can contact Sarah at

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