Revenue Cycle Management
Healthcare Blog

It just ain't gettin' any easier is it?

Over the past few years, we’ve seen the Affordable Care Act receive much scrutiny and attention for its individual and employer mandate requirements. With the ACA presenting so many details and implications to understand and address, the Internal Revenue Service’s proposed 501(r) might have seemed buried under a heap of your other patient accounting and revenue cycle priorities.  But the new code addendum has the potential to significantly impact tax-exempt hospitals’ ability to bill and collect payment if not properly addressed.  In the midst of ICD-10’s certain implementation later this year and the insurance denial complexities it almost promises to deliver, you’re likely looking to avoid any additional delayed or forgone bill payments, right? Getting familiar with the new requirements and taking action to prepare is crucial to minimizing any negative consequences. 

Healthcare systems themselves are convinced there aren’t any practical solutions when it comes to revenue cycle management. As a medical practice, receiving every dollar that is rightfully yours is critical to your overall success and vitality. Therefore, the common question of whether to outsource patient collections or keep the process in-house is one that weighs heavily on many hospitals and practices, regardless of size.

In the past year, services like revenue cycle management have become somewhat of a buzzword in the healthcare industry. ICD-10 was delayed of course, and if your organization wasn’t focused on preparing for that shift, they should have been searching for ways to enhance and strengthen their revenue cycle. After all, most healthcare organizations expect some friction and payment problems after ICD-10 implementation, regardless of your preparation level.

Increasing collections and improving patient satisfaction might sound like two things that will never go together, but they can blend impressively well with the right revenue cycle solution.

Healthcare executives today are faced with a critical challenge: to outsource or not to outsource? It’s the question on everybody’s mind, and for good reason. Choosing between an outsourced or in-house revenue cycle management (RCM) solution isn’t easy, and there is a lot to consider before you make your final decision.

It should come as no surprise that the most successful healthcare business process outsourcing companies have a lot in common with each other. They know how to get the job done the right way, the first time, without any surprises. That's why they're so awesome at what they do.

Patient privacy matters, and that includes protecting them from unwanted phone calls.

TCPA, (Telephone Consumer Protection Act) has done a great job in preventing automated calls absent prior patient consent. But what happens when those phone calls regarding important patient information get blocked?

So you and your team finally have the right denial management solution in place… congrats! I’m sure it took some heavy thinking to get it in a good place—one that improves claim reimbursements and patient satisfaction (the good solutions do)! But, just because you have a strong strategy on paper doesn’t mean your work is over.

No one likes to handle incomplete insurance claims. Not you—or us, frankly. But you know what’s 1,000x more annoying than managing denied claims? Losing out on time and money because you don’t have proven denial management solutions in place to handle those unpaid insurance claims—that’s what.  

There’s a special place in hell reserved for incomplete patient claim denials.

You know the ones—stress-inducing, revenue-compromising, how-the-BLEEP-could-they-forget-to-mention-their-history-of-blood-clots denials that cause you and your organization to sacrifice a lot of money. Millions of dollars in claim denials can build up quickly and if you don’t implement a strategy to reduce and manage your denials, you’re leaving a significant amount of revenue on the table.