What are the Challenges In Hospital Revenue Cycle Management?

Many hospitals are struggling to get their revenue cycle in streamline. As we all know hospitals have a large number of expenses. It is quite difficult for them to get prompt patient payment from insurance companies. To get payment correctly, all hospital systems need to work together to meet revenue goals. Hospitals make sure on which protocols work and why, to execution the best revenue cycle operations.

The reason for most hospitals facing a financial crisis is due to roadblocks in the revenue cycle process. Hospitals need to find ways to remove these barriers. Hospitals need to focus on various aspects such as scheduling, patient registration, and eligibility checks, upfront collections, managing claims, billing and patient collections, etc.

Here are some of the challenges faced by the hospitals,

1. Billing and Collection Mistakes:

Hospitals have a hard time to get a collection from insurance companies. If the hospitals do not have an effective billing process, they may face the situation where the loss of money. Because of high deductible insurance plans, patients are forced to pay lots of money.

From the situation where if the patient is uninsured or under insured there is no way to set the payment plan for the patients. Which leads to not paid in full. These factors make the problems in revenue cycle management and providers risk losing business because adding too much pressure on their patients to pay for the service rendered.

2. Lack of Technology:

We are living the era of technological innovations. For hospitals and other healthcare services, providers need to use effective software systems. Having poor IT infrastructure can harm and worsen the condition.

3. Untrained Staff Members:

The new technologies raise another issue. Which is how to educate your staff members on how to best collect and process patient data. Collecting inaccurate patient data leads to mess all the things like improper medical coding, billing, and insurance claim filing. These errors add costly hospital expenses.

4. Lack of an Effective Financial Policy:

The hospital needs to concentrate on financial policy this is all about revenue cycle management. Having an effective financial policy adds not only safety for revenue cycle, but also added a codified process for how data, bills, and claims are handled.

5. Poor Monitoring of Claims Process:

Insurance claims are tricky customer and it should be handled correctly. At present medical claim, data suggest that hospitals and healthcare providers are lower their claim denials. It is mainly caused due to technical errors such as claim denial addressed quickly and could be managed.

Hospitals facing revenue cycle issues time and time again. It is always a good idea to outsource your hospital revenue cycle management to third-party service providers!