Medical billing is one of the most crucial components in the healthcare business equation. However, the healthcare industry has created a complex monster...
The opportunities for mistakes…astronomical
250 people may potentially be involved in a single patient's bill 1
55% - patient bills containing errors
30% - incorrect insurance verifications 2
Economic Impact of Billing Errors
$17 billion lost to admin. costs due to errors
$125 billion lost to poor billing practices 4
$58 million in improper Medicare CAH outpatient payments
92% caused by insufficient/incorrect documentation
$3.4 billion in improper Medicare hospital outpatient payments
95% caused by insufficient/incorrect documentation
$1.3 billion in improper Medicare inpatient payments 5
47% caused by insufficient/incorrect documentation
50% caused by medical necessity errors
Rural Healthcare Facilities in Trouble
673 rural hospitals currently vulnerable to closing
60+ rural hospitals closed since 2010
68% of closed facilities were CAH
99,000 healthcare jobs at risk
Symptoms of a Struggling Facility
Elevated days in A/R (more than 55 days)
Net collections rate declining
Claims not received by payers
Lack of internal business process controls
Difficulty recruiting and retaining qualified and experienced staff
Failure to Adapt Critically Impacts Bottom Line
Decrease in volume
Changes in payer mix
Deteriorating physician relationships
Poor financial management
Typical (Negative) Solutions
Downsize through layoffs or attrition
Reduce the scope of services provided
Micro-manage employees’ tasks & time
Make administrative pay cut
Seven Positive Solutions to Increase Profitability
Improve the hospital’s reputation through high patient satisfaction. Without a good reputation a hospital will not achieve success financially or otherwise. Its reputation has a fundamental influence on its bottom line.
Re-think billing and collections. When patients don't clearly understand their financial responsibilities they are less likely to pay on time (or at all).
Focus on communication strategies. Communication is a crucial link between your clinical efficiency and a patient’s experience.
Increase patient satisfaction by providing high quality customer service.
Focus on limiting readmission regulatory penalties.
Reduce unnecessary testing whenever possible.
Get a complete understanding of your revenue cycle performance
For more information, contact Medical Recovery Services
Medical Recovery Services is a full-service revenue cycle company assisting
hospitals and surgical centers in achieving their full earning potential since 2004.