3 Revenue Cycle Management Challenges and How to Overcome Them

 

Suppose you have ever encountered or worked in a healthcare organization. In that case, you are aware of the significance of medical claims and how, if they are rejected, they can negatively impact your revenue cycle. A healthcare facility's administrative tasks are distinct from those in other sectors because clinical treatments, from the patient's appointment to the account closure, are frequently lengthy and complicated. 

The non-medical tasks include handling all the paperwork, determining eligibility, entering demographic information, medical billing and coding, and submitting medical claims. The claim will be disproved if even one step is skipped. Because there is no proper process, a disorganized revenue cycle management can result in a stockpile of uncollectible. 

Revenue Cycle Management: What Is It? 

Revenue cycle management (RCM) is the financial procedure used by healthcare organizations to monitor a patient's activities. In contrast, a patient is a part of their facility, from registration to appointment scheduling to settling any outstanding balances. 

RCM unifies the clinical and administrative aspects of healthcare by fusing vital electronic health records with the care they have received.  

Top Revenue Cycle Management Challenges 

The secret to medical practices' continued financial security and ability to concentrate on their primary goal of delivering high-quality patient care is organized revenue cycle management. Facilities, however, need help to improve for a variety of reasons. Here are some of the challenges faced in Revenue Cycle Management; 

Payment and collection mistakes 

At the initial point of care, while patients are still present, healthcare providers must have the correct information. Your revenue cycle may be negatively impacted by information errors, incorrect ICD-10 coding, and failure to confirm a patient's insurance eligibility.  

Unspecified bills may also affect a patient's understanding of their balance and patient experience management. When prices are opaque or when the amount is unclear to a person, they may decide not to pay their bills. 

Processing and observing claims manually 

Many clinics and hospitals need more resources or infrastructure to update the systems that monitor the revenue cycle. The majority of them still rely on manual claim processing and follow-up work. 

Manual processes can be unreliable and time-consuming for your employees when combined with a flawed outdated IT system. Furthermore, it might cost more if people need to learn how to use it properly. 

Having trouble finding the right talent 

A lack of highly skilled workers can also impact your entire revenue cycle management. If your internal team cannot perform their duties, your entire operation could easily suffer. The cost of hiring RCM experts and top professionals directly can make it impractical for a healthcare facility to do so. 

 

The best action is to recognize these problems and implement the solutions. However, it is simpler to say than to do. Finding the right software, training the staff, putting it into practice, and bringing it together can take time and effort. Fortunately, you can work with an outsourcing firm like TalkEHR to assemble a robust RCM software and team for your medical practice.