Solving the Biggest Pain Points in Revenue Cycle Management

The healthcare industry is facing an incredibly complex problem: How can accounts receivable professionals increase profitability while solving staffing shortages, inefficient processes, billing errors, coding errors, denials, and underpayments? With so many challenges hitting the healthcare sector all at once, it’s no wonder that CFOs of hospitals and physician groups are feeling overwhelmed. The good news is, there are solutions to these issues. In this blog post, we will look at how to tackle the top pain points in revenue cycle management and how technology can help streamline the RCM process for better efficiency. 

RCM STAFF SHORTAGES ARE DRAINING REVENUE

First, let’s address the issue of staffing shortages. This is a huge problem within healthcare, as it is incredibly difficult to find qualified individuals to fill revenue cycle positions. To combat this issue, many organizations are turning to technology in order to automate some of the more tedious tasks associated with revenue cycle management.

By automating simple tasks such as eligibility checks, prior authorizations and even patient billing notifications, revenue cycle professionals can focus on more complex areas of their job. Additionally, this automation can help reduce administrative errors and improve overall efficiency.  

InefficieNCY LEAVES CASH IN ar

Next, let’s talk about inefficient processes. The complexity of the healthcare industry has led to a wide variety of different processes that must be followed in order for revenue cycle professionals to properly manage accounts receivable (AR). Many times these processes are too complex or outdated and can lead to costly delays in payments or other issues.

To combat this problem, organizations should look into leveraging technology solutions that can help streamline the process and make it more efficient. Solutions like automated workflows and analytics tools can help revenue cycle professionals quickly identify areas of improvement and focus on those first in order to ensure they are following best practices when managing AR. 

pRESSURE DRIVES LOSSES FROM CODING ERRORS

Coding errors driven by pressure to do more in less time can cause a third major pain point for healthcare providers that often leads to denials or underpayments from insurers. This is a common problem that can be avoided if the provider staff follows proper training protocols.

Providers should take the time to train new hires on proper coding procedures so that they understand how to use certain codes in specific scenarios to avoid mistakes. Providers should also investigate using coding software that automatically checks codes against current medical guidelines and alerts them if any changes need to be made before submitting claims for reimbursement from insurers. 

BILLING ERRORS CAUSE FURTHER LOSSES

Finally, billing errors are another massive pain point for healthcare providers due to their potential financial impact on an organization’s bottom line. Many times, these errors stem from outdated systems or manual processes, which require a great deal of overhead time from staff members to process claims correctly and efficiently.

To solve this problem, providers should invest in billing software solutions that provide detailed information about each claim as it goes through its lifecycle within the system to identify and correct any errors before sending for final submission for reimbursement from insurers. 

RELATED CONTENT: How to Improve Your Healthcare AR with RCM Automation

Technology can help

There are many challenges facing healthcare today. Yet, the right technological solutions and proper training measures can increase profitability for hospitals and systems.

The solutions solve the top pain points related to revenue cycle management - staffing shortages, inefficient processes, billing errors, coding errors, and denials/underpayments associated with medical claims reimbursement from insurers. By taking advantage of modern technological advances such as automated workflows, analytics tools, and billing software solutions, CFOs of hospitals and physician groups will reduce administrative costs while increasing overall efficiency within their organizations’ revenue cycle departments - leading to greater financial success!