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Tuesday December 27, 2022

3 Strategies for Improved Revenue Cycle Performance

The University of North Carolina's Cecil G. Sheps Center for Health Services Research recently concluded that approximately 184 rural hospitals have closed since January 2005. Visitors to UNC's website can view these closures on an interactive map.

With the rate at which community hospitals are shutting their doors, protecting the bottom line has become critical to providing for community health needs and protecting hometown economies.

As a dedicated business services partner to rural hospitals across the United States, MEDHOST provides several ways to enhance hospital leadership's productivity and decision-making capabilities. Specifically, we can help encourage quick returns by focusing our efforts in three critical areas:

  • Denied claims
  • Contract management
  • Accounts receivable

Resolving Denied Claims

Despite breakthroughs in medical technology and a decreasing number of uninsured patients, hospitals continue to struggle with getting paid the right amount for the right services at the right time. Denials are a widespread and chronic issue, with one out of every five claims being delayed or refused. The issue is so pervasive, many smaller providers have given up on denial follow-up altogether.

Fortunately, there are leading practices that healthcare administrators can deploy when attacking denials, regardless of an organization's size. First, hospitals need the right tools to analyze revenue cycle data and uncover the root causes of denials. Next, input from subject matter experts is necessary to help create an action plan that addresses those issues.

Leveraging EHR software with analytics capabilities, as well as the support of business services experts, can help prevent denials by automating claims review to ensure data is accurate and complete before submission, flagging outstanding claims for follow-up, and providing opportunities to correct inaccurate or missing data through an expertly governed process.

Contract Management

Another way to reduce the likelihood of denied claims and help ensure maximum reimbursement from payers is to regularly review contracts and track whether reimbursements match expectations.

For smaller hospital A/R teams, however, contract management is often a serious challenge, especially if they're relying on disparate or manual tools. The other issues are experience and expertise. When contracts are updated without the scrutiny of a seasoned negotiator, hospitals risk forfeiting complete reimbursements due to changing codes or vague contract language that payers use to their advantage.

The longer a hospital waits to address these underpayments, the less likely it is to recover missing revenue. A robust contract management tool that works seamlessly within the hospital's EHR can streamline this process, provide oversight of contract maintenance, support underpayment tracking, and help improve cash flow.

Reduce A/R Time

The longer it takes for a hospital to go from care completion to reimbursement collection, the more risk there is for cash flow leaks. To prevent money from slipping through the cracks, hospitals should take a hard look at how long claims spend in accounts receivable and identify and remedy delays as much as possible.

An effective revenue cycle solutions tool can reveal the sources of delay: provider lags in delivering documentation, A/R time to file claims, lengthy waits for payer reimbursement, missing data that results in communication loops, and whatever else may be causing bottlenecks.

MEDHOST Revenue Cycle Solutions

MEDHOST revenue cycle solutions can improve your hospital's bottom line by streamlining and automating processes, relieving strain on staff, and extending your capabilities through an ongoing partnership.

If you would like to improve your revenue cycle today, get in touch with us at inquiries@medhost.com or call 1.800.383.6278 to learn more.

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