Did you know that a recent report showed that hospitals lose $262 billion in healthcare revenue cycle inefficiencies?
That's a shockingly large amount of money to lose over something that could be significantly improved.
The easiest way to help reduce these inefficiencies is to use technology to your advantage. Various technologies can help reduce most of the issues that occur throughout the revenue cycle process.
In today’s blog, we’ll dive into what revenue cycle management (RCM) is and how technologies are helping streamline its process.
Table of Contents
What is Revenue Cycle Management?
Before talking about the technologies in the revenue cycle, it is important to have a baseline understanding of what RCM really is.
Revenue cycle management is a comprehensive process that helps allow your organization to run smoothly throughout the billing process. The cycle helps allow for minimal errors, creating a streamlined flow of payments. By optimizing RCM, healthcare offices can ensure payments get received on time, without any unnecessary delays.
Now you may be wondering, when the revenue cycle management process begins. Shockingly the cycle doesn't start at the point of patient care. It begins as soon as the patient schedules the appointment.
Key Technologies Driving RCM
The use of technologies is helping to streamline billing processes, reducing any errors and allowing the healthcare provider to get paid faster.
Electronic Health Records
Electronic Health Records, also known as EHRs, is a digital platform healthcare organizations use to track patients' files online. EHRs make it easier for organizations to organize health records making them easily accessible. With the records being completely online, it makes it easier to share information across providers, without having to fax them over.
Automated Billing and Coding Software
Did you know that 80% of medical bills contain at least one error? Automated RCM Technologies helps reduce these errors by analyzing documentation, and ensuring the correct codes are being applied.
The integration of new automation of RCM technologies, helps streamline the process reducing the chances of human error. The automation helps increase the time it takes for claim submissions and quicker reimbursements.
AI in Revenue Cycle Management
The use of AI-powered tools is helping change the RCM by enabling potential claim issues before they pop up. These tools can do this by analyzing old data, and searching for patterns in past claims that may have been denied. With this, the AI can use predictive analytics to forecast future trends and work to prevent them.
How can RCM software benefit my healthcare practice?
Having gone over the basics of what RCM is, and what technologies that are being used during the overall revenue cycle. Let’s go over why RCM technologies can benefit your organization.
Improved Cash Flow and Financial Management
RCM technology helps improve the cash flow by streamlining the billing and claims process, allowing the physician’s office to get payment faster. This happens by the use of automated billing, coding and claim submission, the RCM system reduces human error and the chance of a claim denial. Therefore allowing providers to receive payments faster, and reducing any additional overhead costs that are tied to claim denials.
Increased Efficiency and Productivity
One of the biggest benefits of RCM technology is that it allows your office staff to focus on other tasks. The technology can handle repetitive tasks like claim submission, freeing up your staff to focus on more complex and value-added activities.
Data-Driven Insights
When the RCM technology is analyzing data, it may find insights that your organization can benefit from. It can be recent trends in the industry or ways to optimize your current organization's billing process. Allowing your office to stay on top of the ever-changing landscape.
The use of effective RCM technology can help improve the financial performance of your organization, allowing for increased efficiency and productivity.
Challenges of Revenue Cycle Management Technologies
Now that you are familiar with RCM and some of its benefits, I'm afraid it's time to talk about some of the challenges your organization may face.
Integration with Existing Systems
If you decide that the use of RCM technology is right for your organization, the integration of the technology can be troublesome. Due to a lot of records being online, any new technology you adopt must be able to work together seamlessly. That is why it is so vital to perform extensive research before adopting technology to ensure compatibility and a smooth workflow.
Cost of Implementation and Maintenance
Once you have decided what technology to implement, it is not smooth sailing from there. Unfortunately, the implementation of new technology can be costly for organizations. Depending on the technology you want to implement, you may need to make a larger investment, like computers or other complex systems, which can be costly. If your organization already has the physical equipment, there are still other costs associated with a new system. These costs could relate to your organization's ongoing training or software updates.
Regulatory Compliance
Like all organizations in the healthcare industry, you must navigate the constantly changing regulations you need to stay compliant with. Your organization’s RCM technologies are no exception and must also remain compliant. The technologies must have compliance tracking software, to help stay on top of the ever changing regulations to ensure constant compliance.
Staff Training and Adaptation
With the addition of new technology, your staff is not going to know how to use it right off the bat, and they may be resistant to adopting it if it looks overly complicated. It is vital that when choosing which technology to use, it is intuitive and user-friendly to reduce the learning curve. Your organization should also offer ongoing training and support to ensure that the staff can effectively use the RCM technology.
Understanding the challenges your organization could face is important to be aware of before deciding whether RCM systems are right for your organization. This allows you to prepare for the challenges before they occur, reducing any chance of you getting blindsided.
The Role of AI in Optimizing Revenue Cycle
Did you know that 46% of hospitals and health systems already utilize AI in their RCM systems?
With the growth of AI, this is just the beginning as the future of RCM will likely receive influence from AI advancements. AI can help streamline the process helping automate more mundane tasks like claim processing, coding and even dealing with denials.
Machine learning technologies can also be very useful when dealing with denial management. With more and more advanced systems, machine learning technologies can help identify and give an explanation of why the denial occurred. This can help streamline the medical billing process, as managing denials is difficult.
Conclusion
Utilizing healthcare revenue cycle management technology can help streamline the billing process, letting the physician get paid faster. With the use of AI, it can help complete those repetitive tasks that your office staff dreads, freeing them to do more value-added activities.
It is vital to understand the challenges of RCM technology, like integrating the systems, constant staff training, and compliance regulations. Understanding what challenges you may face allows you to be better prepared when deciding on whether integrating RCM technology is right for you.
