Read to know the major Revenue Cycle Management challenges to be faced by providers this year
One stark reality that stares physician practices in 2022 is that they need to overhaul their revenue cycle management process to turn prospects around. This is because traditionally ways of delivering bottom line have failed to deliver in the last 2 years and therefore can no longer be a viable option in future.
The pandemic has brought about huge shifts in the way payers reimburse claims. It has, in principle, exposed the drawbacks of existing systems some of which include the perils of staff shortage, siloed processes, improper denial management and patient outstanding.
The one reason that can be attributed to the malaise is absence of structured data and, consequently, failure to obtain proper corrective insights. This is the one thing that need to be set right in 2022 so that providers can execute tasks based on actionable intelligence and have a proper estimation of financial outcomes. In short this means trying to understand what is causing money to be left on the table and what needs to be plugged to stop the leak.
Staff Shortage Will Continue
In 2022, healthcare organizations will face severe skilled staff shortages across the board. This will disrupt work processes and impact profitability in major ways. Beside shortage of skilled staff, providers will also have to deal with the challenge of retaining effective billing staff. As an effective billing team can make all the difference generating and losing revenue, providers will have go all out to ensure staffing problems do not affect their earnings.
One possible solution that providers will explore in 2022 is embracing advanced tools. This will help them become less resource dependable. One such tool is automation. Automated tools will eliminate the need to have more resources to run healthcare revenue cycle management. Besides, it will make the most of available staff resources.
Besides, automation providers will also look for other ways to make for resource shortages. One option available before them is virtual recruitment. These are essentially skilled staff working from remote locations. Having virtual staff on their pay roll, will not just help them eliminate billing staff shortage, but will also enable them promote better employee environments. Today, a proven way to ensure greater work productivity and a guaranteed retention policy is to provide billers with greater work-life balance.
However, virtual recruitment will come with its own set of challenges. Therefore, another option available before providers is outsourcing healthcare revenue cycle management. Today, finding an expert medical billing vendor is no longer a challenge. This is because several billing companies with proven credentials have emerged in the horizon. These companies are driven by expert and experienced professionals. They also bank on advanced technology such as one that provide “real-time” transparency. Providers can therefore keep an eye on the effectiveness of revenue cycle process more effectively.
Pressing Need to Increase Profit Margin
In 2022, the net collection rate for most providers was very less. Therefore, in 2022 profit margins will matter more than anything else. Providers will try to break free from the sharp operational limits that have marked healthcare operations in the past 2 years. The make-or-break effort will help them position themselves for sustainability and growth in a post-pandemic age.
A good way to improve collection rate will be getting real-time visibility into financial and staff performance and streamlining processes by deploying intelligence. SO, providers will go the whole hog to adopt tech-enabled solutions such as automation to improve their bottom line. In addition, they will embrace a lean process to minimize write-offs.
This year, providers will also explore the possibility of attracting equity investors. For instance, systems treating patients outside hospital premises is a possibility. In fact, policies are being drafted to incentivize hospitals deliver such treatments. Providers are also exploring the possibility of making profits by implementing cost-cutting measures. Some of these measures include developing new staffing models, shifting patients to outpatient services, and reducing administrative and supply costs. The revenue potential of developing a physician network is also being tapped into. Yet another available option is growth through mergers and acquisitions (M&A).
Processing Data from Disparate Systems
One big failing of providers in 2021, was inability to get insights from data. This made it hard for them to forecast financial performance and tighten loose ends. As a result, they had to put up fall in revenue. In 2002, providers need to make a departure from this practice. They need to have the right tools and process in place to get improved and accurate insights from their data. This will help them acquire the intelligence to optimize operations and overall financial health.
This year, providers must shun the practice of depending on legacy EMR or PM systems to get revenue intelligence. The best way to get insight is with automated workflows. Such solutions can organize, store and analyze data and present accurate insights on upcoming trends. This way you get prepared for financial outcomes.
Large practices that bank on multiple systems can particularly gain from this practice. Automated solutions collect disparate data from all the systems in a central repository and use analytics to compute the total A/R —factoring in denials, patient dues, past balances, pending claims and partial pays. This way they can identify a host of overlooked aspects such as primary causes, new opportunities, and even the overall impact of process changes.
Embracing Self-Service Methods to Improve Patient Experience
In 2022, providers will have to brace up for yet another major struggle – collecting money from patients. This is because, this year patients will continue to be responsible for more of their healthcare bills. The struggle should be viewed in light of a 2021 report that underscored that providers could collect only 55% of the amount owed from patients. Further, the report stated that it took providers a minimum of 3 months to collect the patient’s share of reimbursement.
One trend that made its way during the pandemic is self-service solutions. These solutions that manifested itself in the form of apps, portals and kiosks enabled patients to check in, complete paperwork, check and pay balances online, and update demographics on their own before walking in for the appointment. Just as this helped patients, it also enabled providers do away with resources needed at the front desk.
This trend got popular, but not all hospitals were able to implement them during the last 2 years of the pandemic. Therefore, in 2022, all practices and hospitals will go all out to implement this so that they can to do more with less and at the same time make patient experience seamless.
Who We Are and What Makes Us an Expert?
This article is brought to you by Medbilling Experts, a specialized BPO service provider, with over 10 years of experience in assisting US-based healthcare providers manage their back-office processing needs. We specialize in revenue cycle management and deliver services to make payments collection smoother, keep delays and denials at bay, and maximize reimbursements. Get in touch with us for a free consultation regarding your medical revenue cycle management needs.
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