What is Top of Mind for Revenue Cycle Billing Leaders in the Upcoming Years?

As an administrator of the healthcare practice, you’ve faced a lot of obstacles in growing the medical business. But being a successful business leader doesn’t mean that you are now in the safe zone. There will always be additional challenges ahead.

Once you secure a top position in the healthcare market with a considerable loyal customer base. No doubt it’s a great victory. But the most challenging thing is maintaining your reputation in the highly competitive medical industry. In order to stay in the competition, physicians have to embrace the innovations. Particularly, when it comes to improving the patient’s lives and more importantly the management of the revenue cycle.

For instance, in the recent healthcare emergency caused by the ongoing pandemic. Medical providers were supposed to change the strategies of managing physician billing services and dealing with the patients. Moreover, due to the rising trend of telehealth and telemedicine, the healthcare industry has undergone several transformations. As the federal agencies introduced modified codes and billing guidelines for such remote basis healthcare services. Physicians, who didn’t update their billing systems accordingly, end up with the declined reimbursements and lag behind their goals.

After learning from past mistakes, revenue leaders are looking for innovative ways to stay strong against uncertainties & ahead of competitors. In order to break the growth barriers, healthcare providers across the United States are moving towards automation. They are planning to invest time and money in shifting their manual billing to automated systems by the end of 2021. This trend of leveraging technology to improve revenue cycle management has gained pace over the last few years. And is expected to take the entire healthcare industry in upcoming years.

Because of the recent global pandemic pushing the world to work remotely, that isn’t possible without the help of advanced technology. Additionally, generating high revenues & getting out of the financial crisis has become another top priority of revenue cycle billing leaders. For this purpose, the majority of physicians consult with industry experts. Aiming to make some profound changes in their working patterns i.e. managing RCM tasks.

Furthermore, according to a recent survey. Top health system leaders agreed that: revenue cycle management is the most important component of the healthcare industry. That needs innovation and disruption. Just think for a while, if your revenue cycle isn’t on the right track. And you are frequently losing the compensations from the insurance companies and patients as well. Then how can you meet your medical expenses? The answer is clear.

You need a consistent cash flow to meet all the expenses needed to provide quality healthcare services to the patients. When we get in touch with some physicians. They revealed that while keeping in mind the ongoing financial situation. They aim to work diligently to shield their healthcare practices from the future global crisis. The surveyed healthcare providers came up with their own strategies and plan to keep their physician practice running smoothly.

However, for your convenience. We have compiled the following priorities in the article, that every healthcare provider has on the top of their minds. These priorities are crucial to follow for the other physicians to survive in the fast-paced healthcare industry. Read on to know more!

Using Data Analytics For Better Outcomes:

The latest value-based care models, strict policies established by the federal authorities and payers as well as complicated reimbursement models have increased the complexities of physician medical billing services. As a result, healthcare providers are struggling to recover every single penny for the medical service provided to the patients.

Moreover, collecting payments from patients has become another major challenge for physicians. Because the viral pandemic has led to severe unemployment rates all over the world. Which has automatically affected the affordability concern of the patients. However, big data and applied analytics can enable medical practitioners to address these challenges. By offering actionable insights into the revenue cycle, data analytics can play a crucial role in making impactful strategies for the future of the business.

In this way, physicians will get a complete understanding of the areas that need improvements. Therefore, practitioners intend to use modern IT infrastructure systems to make it easier to collect revenue cycle data, track metrics, and apply analytics. It has been observed that hospitals and healthcare facilities, having strong data collection and analytics programs, have more capabilities to measure, compare and get detailed insights into every aspect of the revenue cycle.

Furthermore, industry experts strongly believe that data tells a story and can be used to change the existing policies for dealing with the patients and managing billing tasks. Additionally, moving towards the use of data analytics can create more opportunities for streamlined revenue collections management through diagnostic reporting, root cause analysis, look at healthcare key performance indicators (KPIs) & tracking them to make projections.

Replacing Orthodox Billing Systems

In this challenging era. Patients are looking for advanced payment options to pay their medical bills, without the fear of getting infected. Before diving deeper into the discussion, let it be clear that: medical facilities offering digital payments methods witness more patient collections as compared to those offering manual methods. Therefore, healthcare providers are seriously thinking to make sure that patients can pay their medical bills easily. Moreover, as we have already discussed, physicians are more interested in updating their manual billing systems to the updated ones.

For this purpose, the majority of them have invested in implementing the practice management systems to automate the entire billing tasks. Such as; patient’s onboarding process, medical coding, charge entry, claims preparation & submission, follow up with the insurance companies, denial management, AR recovery, payment posting etc.

Using advanced technology to its fullest potential, fine-tune the entire RCM process and eliminate the inefficiencies. That eventually results in the submission of error-free medical claims and maximum reimbursements as well. Automated administrative workflows not only results in enhanced efficiency. But it also increases the productivity of the staff by reducing their burden and frustration, associated with the manual methods of managing the administrative tasks.

Estimated Medical Cost Break-up

Surprise medical bills are one of the major reasons that healthcare providers lose credibility and patient loyalty. It also holds the patients back from paying their copays and deductibles. That negatively affects the cash flow of a healthcare practice. No doubt out-of-pocket costs, that aren’t covered by the insurance companies, are the responsibility of the patients. But many of the patients complain that they don’t get a clear financial picture before receiving the medical care services.

This situation occurs when healthcare facilities fail to give the estimated costs. That is how much patients will be responsible to pay, in case of a certain medical procedure ending up receiving the medical bills they didn’t expect. This is the major factor that they don’t understand and fulfil their financial responsibility.

The unpaid copays and out-of-pocket costs pile up, which leads to a disruption in the cash flow of the medical practices. Therefore, healthcare revenue leaders are committed to increasing payment transparency by using systems backed by Artificial Intelligence support. They intend to utilize user-friendly systems that help patients to have an estimate of medical costs. In this way, patients can become better able to make informed decisions about receiving healthcare services.

Controlled Capital Costs

Hospitals around the world had to face unexpected and sudden expenditures to fight against the ongoing pandemic. Therefore, the physicians are in high need of adopting the solutions. That can help them to get paid more with controlled capital costs.

It may seem simple. But it’s a fact that managing an in-house RCM department can result in a quick add up in your budget. Such as; recruitment of certified billers and coders, their constant training, higher salaries, annual increments, incentives, office workspace, purchase and maintenance of the cutting-edge software/hardware, required for the successful execution of physician billing and coding tasks. Spending a significant amount of money on all these factors is difficult. Because the medical facilities are already struggling with financial uncertainties.

Nevertheless, in order to save valuable time and resources without compromising the quality of medical claims. Physicians, particularly in the U.S. are preferring to outsource their non-core functions i.e. RCM process, to the leading billing collection agencies. They find collaboration with professional physician billing companies immensely beneficial to break the growth plateau. And increase the profitability factor of their healthcare business in a significant way.

By outsourcing, they don’t need to spend a considerable amount of time and money on building an in-house revenue department. Off-shore billing companies can make a huge difference in enhancing your financial viability. They can help you to save approximately 40-45% of hard-earned revenue on operational costs. So, you get the service of the industry experts, having extensive experience in the domain, at affordable rates.

In addition to this: they provide periodic financial reports, supported by data analytics. Which keep you informed about the ongoing process in the revenue cycle and enable you to make wise business decisions.

Final Verdict

Many practices have also struggled with limited in-house teams when it comes to handling the crisis. This has seriously impacted the workflow management of the organizations managing the medical claims efficiently and dealing with a high patient volume simultaneously.

In order to address the overall challenges in managing the medical & non-medical obligations of the healthcare practice without any hassle. Medical care providers have prioritized the above-mentioned areas to drive the best possible results in terms of both patients’ satisfaction and economic sustainability.

If you haven’t already considered any solution to your existing issues. Then now is the right time to take particular actions, as shown by the healthcare revenue leaders. Investing in all the above-mentioned areas might be tough if you are on a tight budget. The best solution here is to outsource your revenue cycle to a trusted billing company!

PBC is the one-stop physician billing services solution for healthcare practitioners across the United States. Our smart RCM solutions are powered by leading-edge technology, help physicians to catch up with their revenue goals without financial and administrative burden. Acquire the assistance of our experts and make your healthcare practice profitable like never before.


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