The U.S. healthcare system is currently transitioning from fee-for-service to value-based care. Still, once that process is complete, it will lose money processing medical bills, managing costs, and collecting revenue. The system’s flaws are especially concerning interactions among payers, providers, and patients.
The Increasing Need for Specialized RCM in Healthcare Today
In this article, we have highlighted the importance and increased need for specialized revenue cycle management solutions in today’s healthcare industry.
The U.S. healthcare system is currently transitioning from fee-for-service to value-based care. Still, once that process is complete, it will lose money processing medical bills, managing costs, and collecting revenue. The system’s flaws are especially concerning interactions among payers, providers, and patients.
Unsurprisingly, COVID-19 has driven important trends in healthcare revenue cycle management (RCM) as both an agent and an accelerant (RCM). Regulations are changing, patient costs are increasing, automation is becoming more important, and significant cultural shifts have forced workers into their homes.
According to CAQH 2016, manual billing systems must improve in the revenue cycle to eat up to 15 cents of every dollar earned. Denials, poor negotiations, and underpayments cause healthcare practices to lose 5–12% of their revenue.
