An article in Healthcare IT News stated that 10% to 20% of claims that are denied can contribute to approximately 90% of missed revenue opportunities. However, a company experienced with RCM is able to maintain quality procedures and measures that keep pace with today’s ever-changing business needs and reimbursement models.
According to the Northern California Spring Conference, California health insurers rejected approximately 1 in every 5 medical claims, approximating $45.7 million in missed revenue between 2002 and 2009 alone (and that doesn’t include claims denied by Blue Shield of California).
Even more alarming are their statistics that a managed care hospital with a net revenue of $50 million may have – at any given time – $5 to $10 million in an open state of denial. Read more
When asked what the key to success is, most business owners will tell you the ability to stay competitive in the marketplace. Staying competitive is particularly important in the health care field where the financial success of a physician practice is fundamentally based on provider productivity and revenue cycle management. A practice that’s unable to reduce revenue leaks and increase their bottom line will have a hard time staying afloat.
When it comes to minimizing costs and managing revenue, medical practices of all sizes make the same mistakes. Here are 7 common RCM pitfalls to avoid at all costs.
Not Collecting at Point of Service
Not everyone is comfortable collecting from patients at point of service (POS), but avoiding this sometimes-difficult task can put your practice’s revenue at risk. You know firsthand that copays and reimbursements are a major part of how you and your staff get paid.
Should a payment not occur at POS, a lot of time and money is spent following up and chasing after patients. There are the endless phone calls and emails and paper invoices, and all of those “minor” expenses add up, not to mention the expense of having to hire a collections agency. Multiply these expenses by “X” number of patients and your revenue soon develops a slow and steady leak.
The moral of this RCM scenario is, it’s much harder to get patients to pay once they’ve been treated and are out the door, so make sure your staff has been trained on these procedures and can clearly communicate your collection policies. Read more