5 Most Common Hospital Revenue Cycle Management Challenges
Do you agree with RevCycle Intelligence’s ranking of the top five most common pain points for the hospital revenue cycle?
- Billing and collections errors
- Health information technology challenges
- Lack of staff training
- Failure to monitor the entire claims process
- Failure to have a financial policy
The article is well worth reading, because it offers useful solutions. Given the potential downstream costs that come with adherence to new regulations and a rapidly shifting marketplace, control of these points is incredibly important.
However, nestled in the message of these topics is the specter of inefficiency. The payments side of the revenue cycle is experiencing multiple transitions; patient payments, reimbursements, and payment transformation from paper to electronic, just to name a few. Trying to manage all of these variables at the same time contributes to #2, #4, and #5 above.
Examples include:
- High rates of explanation of benefit forms still in circulation (38% today in hospitals and around 90% in dental)
- Reconciliation/reassociation implementations which are only partially completed
- Denied claim processes which are outdated and inefficient resulting in major leakage
- Correspondence letters which sit idle for days or weeks until being processed
The back end of the revenue cycle is fully controllable by hospitals and physician groups. Solutions exist which can be implemented without patient impact. They have to be fixed ASAP…
Bottom line: Invest wisely in control structures now, or pay ridiculously later!