From Push to Pull: A Smarter Way to Manage Revenue Cycle Flow

If your healthcare revenue cycle still relies on pushing information from one department to the next, you’re operating in yesterday’s model.

In a push-based system, every department—scheduling, registration, coding, billing—focuses on completing its individual tasks, often with little coordination or visibility into what's coming next. The result? Silos. Miscommunication. Delays. Denials. And a lot of rework.

Now imagine the opposite: a pull-based system. Instead of blindly pushing information forward, each step in the process pulls what it needs, when it’s ready. This approach requires departments to collaborate, communicate, and share responsibility for the overall outcome—not just their own piece of the puzzle.

Pull systems keep work-in-progress limited, which means errors are caught earlier, resources aren’t overwhelmed, and teams must coordinate to keep things moving. It’s a natural way to break down silos and encourage true accountability.

And yes—this is a paradigm shift, especially for those who’ve grown up in reactive environments where speed over accuracy ruled the day. But in healthcare, where delays, denials, and documentation errors are costly, this change isn’t just helpful—it’s essential.

This isn’t about replacing departments—it’s about integrating them. When the team is accountable for the flow, not just the task, that’s where transformation happens.

🛠️ So, How Do I Start This Transition?

Shifting from a push system to a pull system doesn’t happen overnight—but here’s how you can begin:

1. Map Your Current Flow

   
   

   Start by identifying the steps in your revenue cycle and where handoffs occur. Look at delays, rework, and where things pile up.

2. Start with One Area

   
   

   Choose one part of the cycle—like documentation and coding—and experiment with pulling work only when the next step is ready. Limit how much is in progress at any time.

3. Involve the Team

   
   

   Pull systems thrive on shared responsibility. Hold collaborative meetings across departments to discuss pain points and design solutions together.

4. Measure Flow, Not Just Task Completion

   
   

   Begin tracking how long it takes work to move from start to finish—not just whether someone "did their part." This highlights where things get stuck.

5. Create Visuals

   
   

   Use dashboards or simple whiteboards to show where work is, what’s waiting, and what’s blocking flow. Visibility builds awareness.