According to FinThrive’s 2024 RCM Transformative Trends Report, which surveyed 92 healthcare finance executives, 70% said increasing revenue was their top goal this year.
But what strategies need to be implemented to capture every dollar?
Healthcare leaders say it starts with denials.
The burden is only getting heavier for hospitals and health systems
Denials also impact healthcare organizations’ bottom lines
Denial write-offs are only getting worse
Inaccurate or Insufficient Documentation
Problem: Incomplete patient information, missing signatures and illegible paperwork can lead to claim rejection
Solution: Verify information during pre-service with digital registration and patient scheduling solutions
Prior Authorizations
Problem: Disconnection or miscommunication between providers and payers makes it difficult to obtain necessary authorization prior to care
Solution: Streamline authorization processes with electronic, real-time solutions that facilitate better communication with payers
Coding Errors
Problem: Mismatched diagnosis and procedure codes or incorrect modifiers
Solution: Invest in coding education and training for staff, conduct regular audits and compliance checks to identify and fix coding errors quickly
Timely Filing Limit Exceeded
Problem: Failure to meet payer deadlines of when claims must be submitted
Solution: Utilize sophisticated claims technology to ensure timely claim submissions
Insurance Coverage Issues
Problem: Expired policies or services not covered under a patient’s plan
Solution: Verify insurance coverage and eligibility prior to billing with an insurance discovery solution
Point Solution Overload
Problem: Too many siloed technologies where data is not democratized, analyzed and centralized
Solution: Look to a revenue cycle management platform that offers end-to-end revenue protection across eligibility, claims and revenue integrity
Need a new strategy on how your healthcare organization should prevent or manage denials?
Discover expert strategies to mitigate denials and boost revenue in our comprehensive Denial Management Best Practices Guide.
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