Why Are You Failing at Your Revenue Cycle Management?
In the healthcare market, there is a lot of shifting sand due to changing healthcare regulations and evolving revenue cycle management. Healthcare providers require excellent billing and tracking methods in addition to staying current on amendments to the Affordable Care Act (ACA), Medicaid, and other healthcare programmes. Although these, though, must adjust to changing times and requirements. Unfortunately, the absence of solid basis in these areas creates lots of new challenges for hospital revenue cycle management.
Errors are bound to occur, hindering the hospital’s ability to develop and provide services. Hiring trusted individuals in this industry can assist hospitals in addressing these typical issues that might obstruct the efficient treatment of patients. Here are five reasons why you may be failing at your revenue Cycle Management Cycle, along with suggestions of how to overcome them.
1. Errors in Billing and Collections
If a hospital or other healthcare facility does not have an effective billing procedure, it risks losing a significant amount of money, ranging from thousands to millions of dollars every year. Patients are paying more out of cash as high-deductible insurance plans become more widespread. If the patient is uninsured or underfunded, issues arise since the hospital has no assured way of payment other than setting up a payment plan, which may or may not be fully paid.
Furthermore, if there is minimal pricing transparency and patients’ bills are complex, they are significantly less likely to pay in whole. These considerations place revenue cycle management issues solely on the shoulders of providers, and providers risk losing business if they put too much pressure on their patients to pay for their services. Hospitals must be able to gather the correct information the first time it is requested at the point of service, while patients are still on campus.
Once they’ve moved, it might be very hard to track them down again. Bad debt accumulation is a harmful but often inevitable side consequence of inefficient billing. The first step in our process at Rannsolve is to collect patient data and verify that it is correct and comprehensive before communicating with the healthcare provider. This reduces the likelihood of errors and the accumulation of debt.
2. Technology Issues
Medical records systems may now be integrated with data and efficient electronic authentication thanks to today’s technological gadgets. As of 2012, at least a half-dozen healthcare revenue cycle management technologies have been developed to comply with new ACA standards while still processing patients efficiently. Even more cutting-edge technologies are being developed to aid in the revenue cycle management process. The more providers are aware of these systems, the better equipped they will be to select the system that is most appropriate for their situation or environment.
3. Errors of Staff
The technical issue leads to the second obstacle, which is how to train healthcare providers on how to gather and handle patient data in the most efficient way possible. Patient data is often obtained up front by hospital personnel, but if that data is processed wrongly in any number of ways, inaccurate medical coding, billing, and insurance claim filing are common outcomes. These errors of staff result in high healthcare bills and a lot of bad debt.
Staff members must also be trained and know how to track and follow up on patient information, even if it is correctly collected. Unpaid and late bills when unnoticed might easily get lost in the flow. This is something that Rannsolve can help with.
4. Missing an Effective Financial Policy
RCM in medical billing is all about finances hence, it comes down to the fact that a healthcare business would want a written financial policy to keep the cycle moving smoothly. Lacking one of these can result in a slew of issues for hospital employees. An efficient financial policy provides not just a safety net for revenue cycle management, but also a formalized method for dealing with data, invoices, and insurance claims. With such a strategy in place and workers educated in its use, everyone can end up on the same page. Healthcare firms can also get a sense of peace through legal protection if the procedure has been evaluated by a legal team.
Assuming that the policy is well explained to the patient, the patient will have adequate knowledge and confidence about what to expect during the billing and insurance claims process. Patients will often be more afraid of the uncertainty of a healthcare financial policy and invoices they don’t understand than of having to pay for their care. The income management and eligibility specialists at Rannsolve can also assist you in RCM in medical billing.
5. Missing on Monitoring of Claims
Insurance claims are a difficult industry to navigate. They are the product of several entities working together to figure out money, but with distinct objectives. As a result, they may cause a lot of confusion and irritation for everyone involved. This is why it’s critical to be able to track the claims process from start to finish. Providers and employees will be notified when and why a claim was denied, and billing problems and coding issues will be tracked.
Automated notifications, as well as a well-designed and easy-to-understand IT system, can help with this. This not only aids revenue cycle management at the hospital, but it also ensures that patients get all the information they need to pay their bills. Our experts at Rannsolve have a lot of expertise dealing with insurance claims. You may be sure that you’re getting the right information and reports at the right time because we generally take that part of the process out of the hands of the patients and stay in contact with our healthcare partners.
Conclusion
Discrepancies in your process might result in considerable revenue loss and cash delays as Revenue Cycle Management in healthcare gets more complicated. In such a tough and ever-changing environment, assembling the correct team and conquering various outcomes is a must. We at Rannsolve have extensive knowledge and competence in extending medical services so that you may relax and focus on your treatments while scaling.