Declining reimbursements from insurance companies and the shift of financial responsibility to patients—plus the uncertainties around their ability to pay—means many small rural hospitals may be failing to get reimbursed. To compound the problem, rural hospitals also face lower patient volumes and physician shortages. Often smaller hospitals such as these located in remote areas of the country are unable to hire and retain the staff needed to address billing and collection problems.
Reimbursement challenges are also considerable. Community hospitals are facing tough negotiations with insurance companies, which can be choking reimbursement rates, while high-deductible health plans are placing the onus on patients.
So, what’s the solution for small rural and community hospitals? For most, improving operations will mean addressing the revenue cycle from beginning to end: from patient scheduling and insurance authorization to debt collection.
The solution starts at the hospital registration desk: Mistakes made at this point-of-contact are critical and can result in insurance claims errors. These errors can cascade down throughout the entire revenue cycle chain and delay payments.
When breakdowns in the information-gathering process are corrected and registration employees can collect accurate patient and insurance information upfront, claims can be more easily processed. By adding more efficiency and eliminating the possibility of error, bills will find their way to the appropriate payer, typically resulting in payment in about 30 to 45 days.
Many community hospitals can capitalize on opportunities to increase timely reimbursement and recapture revenue with help from an outside partner capable of accommodating the hospital’s legacy platforms, while working alongside employees to help solve challenges. Your partner should be able to provide services support within the platform the hospital uses and across the entire enterprise, including:
As the architect of the MEDHOST Enterprise product, which includes hospital revenue cycle services and solutions, we have the expertise needed to help optimize a rural hospital’s system and make smart modifications. Once the system is tuned to match hospital workflow, we train hospital staff on how they can get the most out of this powerful tool.
Some of the areas our customers have seen improvements to their revenue cycle management capabilities include:
Contract Management: Dedicated to help ensure hospitals are getting paid-in-full.
Many sites fail to keep up with maintaining their insurance contracts accurately or timely. In addition, contracts are updated often without active variance analysis and reporting, which can make it difficult to understand why a hospital isn’t collecting the full amount. For hospitals struggling to find the personnel or time to accomplish these tasks, our vigilant contract team makes sure these critical details aren’t put on the back burner.
Reporting Service: MEDHOST has a dedicated team for training leaders at local facilities and corporate entities on how to get better results from a robust reporting system.
Through our revenue cycle platform customers can access any element in our database, enabling them to build their own ad hoc reports for financials, clinicals, ED, surgery, or any other departments. For a global view of a hospital business, MEDHOST can also help create custom reports and dashboards based on facility specifications.