The continual battle hospital RCM teams face with clams denials is costing US based healthcare systems $262 billion per year. What’s causing this and what can be done? Sometimes these may be cost based, and sometimes it has to do with a hospital’s own coding system and staff training for same. We take a look.
Clean Claim Rate
Billions. That’s how much claim denials and delayed payments cost hospitals each year. We found some strategic remedies after reviewing the root causes of the problem. It can be solved.
How do hospitals ensure they get paid? Patient access processes need to be streamlined, consistent, and smart in order to maintain healthy hospital revenue cycle management. Combining intelligent patient access software with properly trained registration staff dramatically reduces errors, helping hospitals get paid.
When a hospital has a claim denied, that revenue can be lost. Forever. That is if appropriate actions are not taken promptly when claim denials occur.
In addition to the mounting reporting administrative tasks on providers, other hospital revenue cycle management challenges threaten financial health include billing disputes and prolonged A/R days. Learn what hospitals can do to improve clean claims rates, get paid faster, and mitigate the risk of legal actions.
Utilization management is a review process used to evaluate the medical necessity and appropriateness of healthcare treatments and procedures ordered. What happens when patients are being denied access to essential treatment through this met
What can hospitals do to improve their claims denials management process? We review some facts about claims denials, and share valuable advice as to how hospitals should address the issue head-on.
Regarding claims management, the holy grail for hospitals continues to be a high clean claim rate… but how do you get there? What KPIs — Key Performance Indicators — does your revenue cycle team follow? Is the clinical side dialed into the process? We take a look at some recommendations in this article.