2022 is on track to be the most difficult financial year for hospitals since the beginning of the pandemic.
Hospital patient volumes and medical claims are gradually returning to pre-pandemic levels, as financial pressures continue to mount. More than half of U.S. hospitals (53%) are projected to have negative margins for the remainder of the year, facing billions of dollars in losses, according to a recent report released by the American Hospital Association. Hospitals are also confronting related problems, including increased expenses, workforce shortages, and supply chain disruptions.
These three key revenue cycle trends can help healthcare leaders address these challenges for the rest of 2022 and into 2023.
Identifying and closing revenue cycle gaps.
Inflation and financial worries are high this year, factors likely leading to higher self-pay accounts receivable balances. By evaluating your current Revenue Cycle Management and identifying problems or gaps, you can develop better processes to provide patients with accurate estimates, collect more pre-service payments, and avoid errors and unpaid claims.
Perform a comprehensive review of your A/R. Can you pinpoint the main three causes of revenue loss? How can you work with patients upfront to prevent unpaid self-pay balances? Do you run into recurring billing errors or problems with certain payers? What steps can you take to automate processes and save staff time?
Eliminating claim errors.
Submitting clean claims, free of errors and accompanied by complete documentation, will facilitate faster payments and fewer days in A/R. Make a note of common claim errors that showed up in your A/R review, such as prior authorization information, date and location of service, or codes and modifiers. Use a billing system that minimizes human error and allows you to monitor and follow up on pending claims.
Outsourcing and optimizing revenue cycle processes.
Revenue Cycle Management is time-consuming and challenging when it is the responsibility of in-house staff. With staff shortages and expenses on the rise, many healthcare facilities see the value of outsourcing their transcription, coding, and billing to expert partners. Look for a company that offers full-service Revenue Cycle Management and has high, measurable performance standards and integrates seamlessly into your existing operations. The right partner will improve claim accuracy, reduce denials, increase first pass rates, and ensure you are collecting revenue as efficiently as possible.
Learn how MedTek’s Revenue Cycle Edge sets the gold standard for healthcare Revenue Cycle Management.