As a medical billing company, we are focused on helping healthcare organizations manage their revenue cycle effectively. A recent survey by Health Data Management shows that despite the emphasis on value-based care, revenue cycle management (RCM) continues to be a critical concern for healthcare providers. Medical billing issues are affecting the ability of providers to collect money.

Health Data Management received up to 160 responses from provider organizations. The key findings of the survey are as follows:

  • Nearly 2 out of every 3 respondents said revenue cycle management remains very or extremely important to their organizations.
  • Only a third of respondents reported that their organizations were either very or extremely effective in managing revenue cycle, which includes capturing charges, submitting claims and bills, collecting payment, and managing the complex accounting process.
  • 28 percent of respondents said their organizations were only somewhat effective in revenue cycle management.
  • 60 percent of respondents believe that the electronic medical record plays either an extremely critical role (27 percent) or a very critical role (33 percent) in managing their organizations’ revenue cycle.
  • 62 percent of respondents drew attention to the importance of automation in improving charge capture and promoting RCM efficiency.
  • Providers said that improving revenue management has become more complicated in recent years, even with increasing use of information technology. This is due to lack of interoperability and other technology limitations which complicate the movement of clinical information complex.
  • Most of the respondents saw real-time electronic claims submission and adjudication as critical to RCM success.
  • 60 percent of respondents believe that the electronic medical record plays either an extremely critical role (27 percent) or a very critical role (33 percent) in managing their organizations’revenue cycle.
  • Use of electronic transaction standards was believed to be extremely critical by 29 percent and very critical by 27 percent of respondents.
  • 62 percent of respondents highlighted the importance of automation that improves charge capture, with that percentage equally split between those who believe it’s extremely critical and very critical to success in RCM.
  • 51 percent of respondents viewed automated payment posting as either extremely critical of very critical.
  • 50 percent of respondents viewed credit-card processing for patient payments at the time of service as either extremely or very critical.
  • 37 percent of respondents considered automated patient reminders as either extremely critical by very critical.

Despite the importance of proper revenue cycle management, a recent Black Book  survey revealed that about one-quarter of US hospitals (26 percent) do not have a workable healthcare RCM solution in place (www. revcycleintelligence.com). Up to 4,640 individuals from 522 hospitals and healthcare delivery networks were surveyed on their use of 165 revenue cycle management technology services and solutions.

To make the transition to value-based reimbursement, providers need effective RCM solutions. Without this, they could end up losing revenue. According to public accounting, consulting, and technology firm Crowe, patient access and medical billing and collections are among the top healthcare revenue cycle risk areas for healthcare providers in 2019.

With the need to keep abreast of ongoing changes in medical codes and control administrative costs, outsourcing medical billing can be an effective option to streamline billing processes and improve practice efficiency and cash flow. In fact, according to a recent market survey from Absolute Reports, the global medical billing outsourcing market is expected to register a CAGR of 10.5% during the forecast period, 2018 to 2023. The report notes that over 20% of a physician’s revenue gets lost due to loopholes and mistakes in the medical billing process, which has created an increasing need for efficient and skilled professionals to handle the process. According to the report, other factors driving the growth of the medical billing market are growing emphasis on compliance and risk management and efforts to contain and decrease in-house processing costs.

A medical billing company will manage everything from patient scheduling, medical insurance eligibility verification, and patient account establishment to coding, claim submission, payment posting, statement processing, collections, and handling claims denials. With efficient medical billing services, providers can rest assured that they will get paid the full amount for their services as quickly as possible.