Healthcare reforms have built a certain level of pressure over healthcare service providers. This has led to the priority of these organizations changing to an effective revenue cycle management system. Considering the dynamic nature of the healthcare industry and its revenue, this is vital. It helps the business to adapt to the evolvement in the revenue cycle. It has been observed that professionals have to tackle challenges in this regard. These difficulties can range from mere billing errors to failure in processes or policies. It is due to such challenges that an organization makes sure to improve their revenue cycle as much as possible. The challenges that healthcare facilities face in relation to the revenue cycle include:
- Errors related to billing and collections
Billing processes can deprive a hospital of tens of millions of dollars. It may also leave a bad impact on patients who have huge debts that they are unable to pay. The smooth functioning of a hospital is dependent upon the revenue it earns. Therefore, it is important for medical billing companies to focus upon the uncollected revenue. However, patients need to be taken into consideration too. If they are burdened with high payments, they might turn to other facilities for their care purposes.
The revenue collection becomes a difficult task once patients leave the campus. This means that collection at the point of service system must be adopted by the organization. Along with this, other streamline methods must also be considered. This would help the business to maintain financial stability in the dynamic industry of healthcare. With payments that are received without any delay, efficiency and effectiveness will improve. Therefore, the company will be able to uphold its quality and integrity.
- Challenges in healthcare technology
Technology requires skills that can make use of the technology efficiently. Healthcare professionals are required to use new systems that help them in revenue collection. These systems have to be managed properly in order to work. Hospitals are not always aware of how to make use of it. Therefore, they need to acquire the necessary skills.
This reason also contributes to the fact that certain hospitals do not invest in new technology. This is especially evident in small and rural organizations. Without the updated technologies to help them, they end up consolidating or outsourcing. In worse cases, it may even result in shut down.
Investment in technologies also requires hefty payment which is not possible for all businesses. They have to determine which technologies must take priority. Information technology consultants may prove helpful in this regard. An onsite IT expert maybe even more of a beneficial decision for the healthcare facility.
- Staff training
Inability of staff to handle the systems installed for efficiency can decrease its effectiveness. They will be unable to enter the correct data. Without proper data, the insurance claims collections may not take place as easily as it is supposed to. This data lays the groundwork for the ease of collections. Therefore, training is vital if you hope to ensure the productivity of a system. Training can prove to be time-consuming and costly for the providers. However, it may pay off in the long term. It will eliminate the coding errors and other inaccuracies in the data. Billing and coding staff will stay up to date with new skills and thus, reduce any errors that can cause denial of payments.
- Failure in Monitoring
The process has to be monitored closely throughout its lifecycle. The inability to do so may negatively affect the revenue management cycle. They will be oblivious to the errors that are taking place. Without the identification of coding issues, its correction would be even more difficult. It will, therefore, result in the loss of revenue. It will be an expensive as well as time-consuming problem for the providers. With time spent on searching the errors, important duties may be neglected. This can have an effect on the reputation of the business on a whole. Once the claims process has been streamlined and made efficient, the business will enjoy a better revenue cycle. Thus, the healthcare organization will have smooth business operations.
- Failure of Having Financial Policy
Policy documentation is absent in some medical billing companies. These policies are vital for revenue cycle management. Therefore, it is important for an organization to set them in place. They can be made available to employees through written or electronic channels. Ease of availability of these documents would eliminate many hindrances.
Policies are kept in place for the guidance of patients as well. It includes information about copayments and unpaid balances. Financial policy is a helpful tool to streamline financial processes. It helps in analyzing the financial liabilities of patients. Along with this, steps to determine a patient’s balance will also be outlined.
Tackling these challenges for the medical billing companies may prove to be a beneficial step. It will allow the healthcare company to unlock the stuck revenue in its processes. Such financial stability will also allow the practices to work towards achieving the targeted revenue goals.