Common Challenges in Healthcare RCM
Overview
Consistency and organization are two of the most significant aspects of financial management in a medical institution. Most clinical treatments involve complicated procedures that require accuracy and quality. That is why you need to have a reliable revenue cycle management process.
Revenue cycle management, or RCM, plays a significant role in your practice. It includes essential documentation, insurance eligibility, billing, coding, claims, demographic entry, incoming payments, etc.
Healthcare facilities benefit from a reliable RCM. On the other hand, it is not without challenges.
Errors and missing information can cause problems in your practice. You could lose money and patients if you handle your healthcare RCM poorly. Here's a way to help you identify the common challenges in your revenue cycle management. Recognizing these challenges can help you and your entire team achieve better results.
Common Challenges in Healthcare Revenue Cycle Management
Here's a compilation of revenue cycle management healthcare challenges:
Violation of Healthcare Compliance Standards
Your RCM should comply with the
Healthcare Information Portability and Accountability Act 1996 or (HIPAA) guidelines. HIPAA violations are one of the most common challenges in healthcare today. Failure to comply could cost you fortunes.
Poor Accounts Receivable/ Claims Management
Poor monitoring of the accounts receivable (A/R) and claims often lead to revenue loss. One example is when a patient denies a claim and the provider fails to identify the process because of their poor management structure. It may sound simple, but it can cause you significant financial damages.
Lack of Staff Training
The entire revenue cycle management is complicated enough for those familiar with its process. Imagine how chaotic it can be for the under trained staff. Mistakes like improper coding, missing items in data collecting, incorrect billing, wrong dates, missed policy reminders, and chart documentation can lead to disastrous results.
Being Process-Centered Approach
The schedule of a doctor and their entire medical team can be pretty full at any given time. As a result, they become more process-centered than ideally needed. Because of this, they often lack empathy, which is a vital key player in their practice. In addition, balancing the quality of care and convenience becomes compromised.
Interoperability Issues
The lack of information exchange between different departments can lead to revenue loss. Healthcare services have different types of information based on their patients' needs, treatment methods, and many more. Therefore, the inability to communicate freely can increase the risks of problems.
How to Improve Revenue Cycle in Healthcare
Identifying the common RCM challenges gives you an advantage. You can create a plan to overcome these challenges to help improve your practice. Here's how.
Reinforce HIPAA Compliance
Use reliable RCM software for your practice. A good quality software ensures HIPAA compliance in more ways than one. Sophisticated medical software allows you to transfer protected patient information without violating the HIPAA guidelines.
Monitor Accounts Receivable/ Claims Reports
Conduct regular accounts receivable and claims check to monitor errors and maintain accuracy. This approach may sound simple, but it does wonders for your overall RCM process. Identifying mistakes can help prevent claim denials and delays. Like our example earlier, you can provide answers to a patient's claim denial by referring to your reports.
Providing Training to Employees
Refresher courses are always beneficial in revenue cycle management. Your employees will get all the necessary updates to manage relevant information. It also reduces the chances of errors and missing data.
Balance Quality of Care and Convenience
Having reliable RCM software lets you focus more on treating your patients. At the same time, your medical staff takes care of the clerical tasks. It creates a balance between the quality of care and convenience. Above all, it provides a positive experience to your patients.
Improve Your Practice's Interoperability
Provide central access to your team so that everyone from different departments can communicate anytime. Use RCM software where they can talk to each other and share files and documents. This capability enhances
interoperability hugely.
Conclusion
As we have concluded, using revenue cycle management software can help you avoid RCM challenges in a big way. It minimizes the errors and inaccuracy by a significant degree in your practice. With sophisticated RCM software, you can get paid faster. And above all else, you can focus on your patient's wellbeing.
On the other hand, finding a reliable team to help you with your revenue cycle management is as important as the tool itself. And that is where we come in.
Partner with DrCatalyst
If you want to maximize your collections for efficient cash management, higher earnings, and spending more time with your patients, contact
DrCatalyst today.
Our Services
- Charge posting
- Claims service
- Payment posting
- A/R Management
- Revenue reports
- Patient statements
- Credentialing services
We design our services to help your practice avoid the common mistakes in revenue cycle management. What's more, we have a dedicated RCM team to take care of all these tasks for you. Schedule a demo by clicking this
link.
We'd love to hear from you soon. At DrCatalyst, you know that you are working with the best. Give us a
call today!
