According to a study conducted by the Council for Affordable Quality Healthcare, inefficient processes across the revenue cycle collectively cost healthcare practices billions of dollars each year. In the United States alone, the industry could have saved $16.3 billion in 2020, or 42% of the $39 billion spent on administrative transactions tracked by the CAQH Index.
Inefficient revenue cycle management (RCM) costs healthcare facilities valuable time and money. The cascading effect prevents institutions from making improvements in innovation, patient care, and facility growth. Although the revenue cycle process can present its share of challenges, it also holds an opportunity for healthcare institutions as it is a crucial area to fix for improved business efficiency and patient satisfaction.
Inaccurate documentation increases the possibility of claim denial. Accurate and audit-proof reimbursement requires that your coding staff stay abreast of current, best-practice coding policies. For example, certified Coders are familiar with specific payer policies and can alert facility staff to any documentation deficiencies that could result in a claim denial, prior to the billing of a case. Once aware, the staff can proactively submit supporting patient medical records for review or approach the physician for improved clinical documentation.
A combination of human and automated processes helps when it comes to strategic collections, ensuring the correct amount is collected in the right time frame. With a combination of automated and human checkpoints at each step of the process from transcription, to coding, to billing and payments your process will be faster, more accurate, and full of intelligence that will improve the overall operations of your center. Facilities should be using the latest technology, including revenue cycle software that sends alerts about errors to prevent a lengthy claim denial and appeal process.
While automation keeps the revenue cycle running efficiently, it takes a trained revenue cycle expert to dig out insights underlying the “days in A/R” metric. Many centers are often blown away when they find out how often they are accepting less than owed or writing off claims that are too difficult to collect. Healthy revenue cycle management means collecting the amount agreed upon in each payor contract and continuing to pursue that claim until it is paid in full.
Looking to increase the speed and efficiency of your revenue cycle? Reach out to MedTek today to see how we can help.