Hospitals are actively considering full revenue cycle management outsourcing. Since 2015, there has been an 86% increase in the number of hospitals that have made the transition to an outsourcing model. This statistic is a testament to the difference that an RCM outsourcing company can make to the financial stability of a healthcare practice.
The healthcare revenue cycle continues to evolve, thanks to the Center for Medicare and Medicaid Services’ (CMS) aim of promoting value-based care. Physicians and doctors are busy with customizing their treatment process to match the ideals of the Affordable Care Act. Many hospitals that participate in the CMS s initiatives need to come up with innovative ways of treatment, to make it both affordable and efficient.
This leaves them with very less room to think about the financial aspects of their care practices.
The Top Hospital Revenue Cycle Management Challenges
Hospitals get bogged down easily with billing errors. These errors negatively impact a hospital’ s revenue cycle and ultimately its profitability. To solve the financial shortcomings in their RCM cycle, hospitals need to understand the challenges that come with it.
The following are the common challenges that a hospital faces regularly.
Billing and Coding Errors: One of the most common problems that hamper the revenue cycle of a hospital is billing and coding errors. These errors make payment collection from insurance companies, difficult. A staggering 85% of hospitals in the United States continue to struggle with medical billing. The services of hospital revenue cycle outsourcing companies help eliminate these recurring errors.
Lack of Dedicated Resources: RCM incurs significant costs. It takes at least a couple of medical billing professions to make a difference in a hospital’s revenue cycle. Unfortunately, an in-house RCM model can never match the efficiency of outsourcing providers who specialize in the management of a hospital’s insurance claims. This is because hospitals need the services of dedicated experts to see an improvement in revenue.
Lapses in the Claims Process: Despite ensuring that the medical billing process is efficient, hospitals stand to lose revenue due to inaccuracies in claims submission process. When healthcare providers do not track claims closely, errors in the claim submission process hurt them. A team of dedicated professionals like hospital revenue cycle outsourcing service providers can easily monitor these errors thanks to their immense experience in handling the RCM process of care providers.
Outdated Technology: Many software suites are both innovative by design and complex in terms of functionality to handle a hospital’s RCM duties. The consist of advanced features such as smart notification, process automation and much more. These systems can be configured to flag missing and wrong information in both the medical billing and claims submission process. Using such technologies helps care providers overcome many process related challenges.
Solving all of these problems listed above helps hospitals increase revenue levels. Hospitals can overcome these challenges effectively, only with assistance from hospital revenue cycle outsourcing companies