Healthcare RCM

  Imagine putting all your money in a bag with a hole! Most of us would wince at such indiscretion, wouldn’t we? But denials, the proverbial holes in the coffers of healthcare businesses are mostly left unmanaged. An average hospital faces a loss of around $5 million in denials every year. And surprisingly, nearly 65% of those denied claims are not resubmitted again! Why do hospitals and healthcare services choose to close their eyes to this gaping drain in their revenues? Well, studies and interviews reveal that most health organizations are deterred by the time, labor, and cost that denial management calls for! So the question that naturally follows is how hospitals can manage their denials without stretching their resources? The recourse we feel lies in a thorough and holistic approach that looks at denial management from every facet and works at it from the base to the top. We need to devise strategies that address the root causes and work at eliminating them. Here are some hel...

Any business, even if it’s a noble service like healthcare can come to naught if payments are not received on time. Mounting accounts receivables and erratic cash flows are problems that many healthcare services are grappling with today. But surprisingly, the solution to these can be quite simple – diligent A/R follow-ups! Industry statistics tell us that not following up on unpaid claims results in nearly a 25% loss in revenue. Then a clear corollary that we can infer from this fact is that  A/R follow-ups  can significantly ramp up your health practice’s revenues.  What Do A/R Follow-ups entail? A/R follow-ups is a systematic process that billing teams or medical billing companies follow to collect the outstanding payments. An A/R follow up process typically includes three main stages.  Evaluation Analysis and Segregation based on Priority Collection Why are A/R follow-ups important? And if the boost in revenue is not enough reason for healthcare companies to focus...

Challenges and the US Healthcare Industry go hand in hand. From constantly evolving payment systems, increasingly labyrinthine regulations to the terrifying Covid-19 Crisis that’s before us today, the challenges we need to counter are many and possibly, never-ending. To surmount these problems and be ever-ready to meet new ones, we must build strength and resilience from within. One way to do that is to focus on improving our  core operational efficiency .  “Operational Excellence remains a greater imperative than most companies and most executives acknowledge,”   says    Gene Tyndall, President Supply Chain Excellence Advisors. This is especially true of the US Healthcare Industry where administrative costs far exceed those of healthcare industries in other comparable countries.  The Centre for American Progress (CAP) estimates that the annual  Billing and Insurance related costs borne by providers and payers are a startling  $4...

Scheduling is one of the simplest and most basic steps in the healthcare revenue cycle. But it is not any less important. As the first context of contact with the patient, it strongly affects the entire experience that a patient has with your healthcare service. A 2017 study by the University of Utah reports that 39% of patients surveyed considered scheduling a timely doctor appointment as the most important expectation they have from a healthcare service. That is not quite surprising when you consider the results of another study. In this one, more than 30 % of the patients under the study with an urgent medical problem reported that they were not able to schedule appointments on time.  So as a  healthcare provider , the first constructive step towards enhancing the quality of care you provide and streamlining your revenue cycle is to improve your patient scheduling process. But how can you do that? Here are six ways that will surely make your scheduling process run a...

Crisis begets change. True to the saying, the Covid-19 crisis we face today has ushered in many changes in the US healthcare system. It has changed the way we see and it has definitely changed the way we do things. For instance, it has transformed the way we deliver healthcare. One of the positive changes that the pandemic has brought about is the acceleration of Telehealth’s foray into mainstream medicine. Telehealth is not by any means new to US healthcare. It was already touted as the fastest-growing medical care service by an AMA study conducted in 2019, pegging the growth rate at a striking rate of 53% with more than 76% of hospitals in the country offering the service. This year the pandemic is slowly yet forcefully pushing this number closer to 100. From big multispecialty hospitals to small single physician practices, every player in the healthcare business is now looking at telehealth as a viable way to continue serving the community with quality healthcare. But...

You have set up your independent medical practice and you’re slowly climbing up the first leg of growth. Then comes the big challenge – the increasing complexity of medical billing. The one question that looms large over your sky at this point is this: ‘To outsource or not to outsource?’ Before arriving at an answer let us look at some facts Nearly 80% of all medical bills have errors and in around one-fourth of these bills, the errors involved a significant amount of money. The average cost to file an initial claim is $ 6.75 while the average cost to rework a denied claim is around 25 $ In the last seven years, there has been a 70% increase in data breaches in the healthcare industry So what do these data tell us? They tell us that precision and attentiveness are absolute musts to reach a satisfactory level of efficiency in medical billing. And we know that efficiency improves when any task is handled with more specialized knowledge and expertise. Medical billing compa...

The COVID-19 Crisis has rattled the world. While the action in most other spheres of business has come to a screeching halt or at least slowed down to a snail’s pace, the healthcare industry is frenetically fighting this dreadful virus from the frontlines. The US Healthcare system has faced many challenges in the past but never before had it encountered a challenge of such a catastrophic scale. The latest CDC  reports  have pegged the confirmed number of persons infected with the virus in the US at a startling 632,548 and deaths at 26,930.  Even without data, we can plainly see that the cost of this crisis on our economy is going to be huge. The UN’s trade agency UNCTAD augurs that in 2020, the loss to the economy brought by COVID-19 can get as high as 1Trillion $. What will be the economic impact of the pandemic on our healthcare system that is already reeling under a heavy cost burden?  The cost of the pandemic for Providers Hospitals are overwhel...