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Tuesday May 31, 2022  |  Luke Marinac

What Rural Hospitals Can Do About Denial Management Right Now

Rural hospitals are an indispensable part of our healthcare system.  

Nearly 60 million Americans rely on small and rural healthcare facilities for their well-being. However, in recent years small-town hospitals have faced significant challenges. Many have been forced to offer limited services or close their doors forever.  According to the American Hospital Association, 59% of the decline in community hospitals between 2015 and 2019 were in rural areas.   

While factors such as workforce recruitment and reduced patient volumes represent just some of the more pressing challenges rural hospitals face, a lack of compensation related to revenue cycle management remains a critical issue. A 2021 Chartis Group report found that 41 percent of these facilities operate on negative margins. 

This means that business offices at rural hospitals are under more pressure than ever to reduce the amount of time accounts are overdue, ensure positive cash flow, recover missing payments and identify the errors that cause denials. However, these hospitals often have fewer hands on deck and more limited access to the latest technology than larger facilities.  

Rural hospitals need access to the resources and know-how that can help them curb operating costs, stick to a budget, and better manage their revenue cycle.  

Here’s how MEDHOST can be a dedicated partner in denial management:  

  • First, we’ll assign knowledgeable and experienced billers to specific insurance payors to familiarize them with payment requirements, delayed payment tactics, and identifying trends. 
  • Next, our Account Follow-Up team will notate all specific and consistent follow-up activities on each patient account within our enterprise system during the payment resolution process. 
  • Finally, our Account Follow-Up team will continue working on outstanding account balances until they are either resolved to a zero balance or moved to patient responsibility.  Some of our follow-up tools include telephone calls to insurance companies, payor portal claim processing, e-faxing, letters and more.  

We know that downtime is essential. One of the drawbacks of traditional account follow-up in small and midsized hospitals is that the work can grind to a halt when someone takes time off. To ensure your staff gets an opportunity to recharge, our team will cross-train within your facility so that unexpected and expected leaves of absence won’t create an interruption of services. 

Our process is totally transparent: 

  • Any clinical denials that we find will be provided back to the hospital denial board or your third party for response. 
  • Our follow-up work is performed directly within the MEDHOST Enterprise system. There is no extraction of data, and we provide real-time updates. 

To learn more about how MEDHOST can help with denial management and account follow-up services, please reach out to us at inquiries@medhost.com or call 1.800.383.6278. 

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