Healthcare RCM

Healthcare service calls for a high degree of compassion and selflessness. But ultimately, a hospital or a doctor’s office is a business too. It has to generate enough revenues to pay the staff, maintain the infrastructure and grow. But thanks to the complexities inherent in the US healthcare system, maintaining a smooth flow of revenues is a challenge for many healthcare practices. In recent years there has been an added twist to the problems that healthcare providers face. The reimbursement model for  healthcare services  has seen a shift towards more patient responsibility. Patient copays now make up 20 % of a practice’s revenue. This shift poses a big challenge for healthcare providers because collecting from patients is more difficult than collecting from insurance companies. That is perhaps why only 60 % of patient copays make it to the practitioner’s accounts. These losses when accumulated make a big dent in the provider’s revenue. According to the American Hos...

Before we get to the reasons why  outsourcing medical billing services  is good, here are some facts to mull over An American Hospitals Association 2019 report has pegged the value of uncompensated hospital care since 2000 at more than $620 billion. A Mckinsey article has reported that out of medical bills exceeding 3000$, a startling 99 % were not paid in full. According to Bloomberg, bankruptcies in the health care sector have more than tripled in 2017. In the first 3  quarters of 2018, 8 hospitals have filed for bankruptcy and 9 hospitals have closed down.  Healthcare providers lose $300 billion a year due to failures in claims processing, payments, billing, and collection of bad debt. These facts call attention to the major problem that US healthcare providers face today – revenue erosion. A lot of factors contribute to this issue. Three major ones are the fragmented nature of the US healthcare system, the complexity of regulations and inefficiencie...

Billing in any other industry is fairly simple. A small bunch of employees or a department can handle the task. But medical billing is an altogether different story. It is a complicated process thanks to the fragmented healthcare system and the complexity of regulations. To get medical billing right you need specialized knowledge, special technology and a whole lot of effort. That’s why most healthcare providers today outsource billing to professional Medical Billing Companies. Tips for Picking The Right Medical Billing Company But again, choosing a medical billing partner is no simple feat too. There are more than 1500  medical billing companies  in the US offering services differentiated by extent, scale, quality, cost and a lot of other factors. How can you as a healthcare provider narrow down the choice to one? We have put together 12 practical tips to help you pick out the perfect medical billing partner who will care for your financial health as diligently as...

Most of us would have heard this famous line popularly attributed to Management Guru, Peter Drucker, “What gets measured, gets managed!”. This saying fits healthcare finance more snugly than it fits any other domain. Most healthcare practitioners or hospitals do not pay enough attention to the financial health of their healthcare business. And so, they do not detect deterioration or seek a cure for it until it is too late! Maybe that’s why in the past few years, bankruptcies in the healthcare sector have doubled. The only solution is for healthcare practices and hospitals to keep close tabs on their key financial metrics. Why do these Metrics Matter? As healthcare professionals, we are not strangers to numbers. Every day we rely on counts and rates to diagnose health problems in our patients and monitor their health. A patient’s critical health parameters are measured and compared against reference values to help us understand what is wrong with the patient and plan the course of...