Medical Billing

Medical Billing and RCM Experts

Overlooked Revenue Opportunities

Staying Alert To Healthcare Overlooked Revenue Opportunities

Overlooked revenue opportunities have a greater influence than ever before. The severity of rising healthcare costs has increased to an unheard-of degree. According to a recent MGMA poll, just 10% of medical practices said their revenues were keeping up with or outpacing the growing expenditures, while 90% said their costs had risen faster than their income.

Disregarded revenue prospects are a significant contributing component to the probable reduction. Practices see changes in their cash flow as a result of rising expenses. If ignored, these sources of earned but unpaid income can have an impact on profitability and seriously disrupt cash flow. 

Healthcare practices may unleash potential financial benefits and improve their entire revenue process by making the effort to identify these hidden income streams. This news update lists typical causes of missed income opportunities and solutions.

Delayed Billing Procedures

A quick and effective billing process is essential for maximizing income sources. Practices run the danger of losing money if charges are not sent out straight away or if rejections are not handled right away.

As this affects when they may bill patients, practices should strive to process charges immediately and submit payments swiftly and properly. Patient dissatisfaction caused by erroneous and late billing might delay payment for the late-practicing vendor since these late invoices may be given priority over those from other vendors that billed patients on time.

Spending effort streamlining billing procedures for accurate and timely submissions may guarantee that practices make use of all potential income streams. To enable efficient secondary billing, claim handling, and rejection management, payments must be posted each day.

Ineffective Denial Management Workflows

Denial management is a crucial component of the revenue cycle. It costs $25.20 on average to correct a claim denial. Incorrectly collected rejection codes will make it harder for practices to provide the proper Follow-Up Reason Codes (FURCs). Practices need to build processes for each FURC to provide efficient denial resolution since different denial codes call for different approaches to resolution.

Operations might become inefficient and financial losses could be significant without adequate procedures. Quick solutions may be used by an ineffective process in place of addressing the main reasons for denials. 

Practices should classify rejections, associate the related FURCs, and build a strict method to work more productively on denials to solve this frequent difficulty. Spend time educating workers when a systematic procedure is in place to guarantee that all denials are handled correctly and the anticipated workflow has been simplified.

Inadequate Technology Utilization

Revenue cycle management may be greatly impacted by improper technology use. Does the present system have the proper configuration to support logical process steps? The system may experience problems with billing operations, which might result in overlooked income opportunities if it is not properly set to provide seamless and uniform processes within the practice.

Practices should engage with their technology supplier to determine the most effective and automated procedures for their system to address these issues. Billing, claim management, and denial resolution procedures are improved through optimization, resulting in better data flow and fewer errors.

Reduced Patient Satisfaction

Patient billing errors, misunderstandings, and a lack of prompt follow-up are all factors that affect patient satisfaction. The interaction between practice staff and patients may get tense if staff members are not properly taught on all policies and procedures. This tense connection may breed mistrust, which might increase patient churn and cost the business money.

Establish a framework for corrective action plans when problems occur, frequently train personnel on all rules and procedures. Also, empower team members to ensure patient happiness. Consider taking things a step further by explicitly explaining these policies to patients and posting them in the office. Patients will feel satisfied knowing that their complaints will be appropriately addressed and that any possible payment delays will be minimized by providing fast billing and excellent customer service.

Finding overlooked revenue opportunities is a difficult but worthwhile endeavor. Any stage of the revenue cycle may see the emergence of these missed chances. Practices may improve their financial health and completely remove untapped income opportunities by tackling these frequently disregarded revenue streams.

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