{"id":24323,"date":"2022-01-11T12:24:55","date_gmt":"2022-01-11T17:24:55","guid":{"rendered":"http:\/\/www.carecloud.com\/continuum\/?p=24323"},"modified":"2025-10-24T14:46:24","modified_gmt":"2025-10-24T14:46:24","slug":"four-consequences-of-poor-revenue-cycle-management","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/four-consequences-of-poor-revenue-cycle-management\/","title":{"rendered":"Four Consequences of Poor Revenue Cycle Management"},"content":{"rendered":"

In the highly regulated and fast-paced environment of healthcare, making sure your practice secures revenue and reimbursement\u00a0should be top of mind. However,\u00a0this task shouldn’t be\u00a0needlessly difficult and time-consuming.\u00a0Thankfully,\u00a0<\/span>revenue cycle management\u00a0<\/span><\/a>(RCM) support services\u00a0can\u00a0help fill in the gaps in your administrative billing processes,\u00a0so you can focus on what really matters, patient care.\u00a0<\/span>\u00a0<\/span><\/p>\n

Revenue cycle management<\/span><\/a>\u00a0can be time-consuming for your staff,\u00a0which is why\u00a0partnering with an RCM support\u00a0provider can\u00a0alleviate pressures associated with tasks\u00a0like eligibility, authorization, billing, claims submission, denial management, accounts receivable, appeals,\u00a0and more.\u00a0Considering that these\u00a0processes\u00a0should be as buttoned up as possible, it\u2019s no wonder why\u00a0<\/span>75% of health systems deployed RCM\u00a0support\u00a0solutions<\/span><\/a>\u00a0during the COVID-19 pandemic.\u00a0<\/span>\u00a0<\/span><\/p>\n

When your practice leaves money on the table,\u00a0the\u00a0result is a poor financial condition,\u00a0a stagnated business, an\u00a0unhealthy working environment,\u00a0and unhappy patients.\u00a0<\/span>\u00a0<\/span><\/p>\n

    \n
  1. \n

    You Could Be Losing a Lot of Money<\/span><\/b>\u00a0<\/span><\/h3>\n<\/li>\n<\/ol>\n

    A poor financial condition is the most obvious\u00a0byproduct of poor RCM. In fact, you could be\u00a0<\/span>losing\u00a0<\/span>up to\u00a020% of your practical income due to\u00a0<\/span>flaws in<\/span>\u00a0your billing\u00a0process<\/span>. This is especially true as the highly regulated healthcare industry becomes more and more\u00a0expensive\u00a0for the average patient,\u00a0and as high-deductible plans become more\u00a0popular.<\/span>\u00a0<\/span><\/p>\n

     <\/p>\n

    Losing revenue for services rendered,\u00a0and challenges associated with securing reimbursement,\u00a0have punched a hole in the side of healthcare providers\u2019 operations, causing massive hemorrhaging in revenue streams across the spectrum. The\u00a0average 250-bed hospital reports\u00a0up to\u00a0<\/span>$11 million in lost revenue<\/span><\/a>\u00a0due to errors in coding and clinical documentation.\u00a0\u00a0<\/span>\u00a0<\/span><\/p>\n

    According to a 2018 study, more than three-quarters of hospitals surveyed said\u00a0<\/span>denials are the biggest challenge they face<\/span><\/a>\u00a0within their\u00a0RCM. If an insurance company refuses to pay, the responsibility\u00a0falls\u00a0on\u00a0the patient.\u00a0Each denial increases your chances of not getting paid.\u00a0<\/span>\u00a0<\/span><\/p>\n

     <\/p>\n

    All these factors can contribute to bad debt, something that\u00a0is rising in the healthcare industry.\u00a0Some studies suggest\u00a0that\u00a0<\/span><over a third of practices face bad debts totaling over $10 million<\/span>. For many, the\u00a0chances\u00a0of\u00a0ever\u00a0recovering bad debt\u00a0are\u00a0extremely\u00a0low.\u00a0<\/span>\u00a0<\/span><\/p>\n

      \n
    1. \n

      No Money, No Growth<\/span><\/b><\/h3>\n<\/li>\n<\/ol>\n

      Without a robust RCM process that ensures you get paid in a timely\u00a0manner,\u00a0your practice will\u00a0have a hard go at\u00a0investing\u00a0in other\u00a0business\u00a0areas.<\/span>\u00a0<\/span><\/p>\n

      A poor RCM process also means you are probably spending much more than you need to. When a clean claim is not submitted, you pay the price, as studies show the\u00a0<\/span>average cost to rework a claim is at least $25<\/span><\/a>.\u00a0And it\u2019s not just the\u00a0re-submission\u00a0fee you have to worry about,\u00a0you\u2019ll also have to\u00a0pay\u00a0your\u00a0administrative\u00a0or billing\u00a0team\u00a0to rework those claims\u00a0as well.\u00a0<\/span>\u00a0<\/span><\/p>\n

      If the patient does not pay, then you will have to spend even more time and money dealing with collections, which\u00a0<\/span>can take months or even years<\/span><\/a>\u00a0to resolve.<\/span>\u00a0<\/span><\/p>\n

       <\/p>\n

      Some studies suggest that hospitals are\u00a0<\/span>missing out on millions<\/span><\/a>\u00a0thanks to\u00a0inferior revenue cycle strategies.\u00a0Money that could be used to add new personnel, purchase new technology, expand into new locations,\u00a0and more.\u00a0<\/span>\u00a0<\/span><\/p>\n

      With\u00a0<\/span>RCM support<\/span><\/a>\u00a0from a trusted technology provider,\u00a0you\u00a0can scale\u00a0your\u00a0practice without having to\u00a0employ\u00a0additional\u00a0in-house\u00a0coders and medical billers.\u00a0<\/span>\u00a0<\/span><\/p>\n

        \n
      1. \n

        You Risk Overworking Your Staff<\/span><\/b><\/h3>\n<\/li>\n<\/ol>\n

        Let\u2019s face it \u2013 when your\u00a0practice is\u00a0not financially stable, expenses get tight\u00a0and morale drops. This\u00a0is a recipe for stress throughout\u00a0your\u00a0entire organization. On a more granular level, a poor RCM process and a disconnect between departments can give your administrative staff even more reason to\u00a0<\/span>resent coming to work.<\/span><\/a>\u00a0<\/span>\u00a0<\/span><\/p>\n

        The RCM process is one of the few processes that transcends\u00a0both\u00a0front-end and back-end operations.\u00a0Front-end administrators\u00a0register new patients, collect\u00a0insurance\u00a0information,\u00a0and\u00a0perform\u00a0important\u00a0prior authorization and\u00a0eligibility\u00a0tasks, while back-end\u00a0billing teams\u00a0submit and manage\u00a0claims,\u00a0denials, and collections.\u00a0<\/span>\u00a0<\/span><\/p>\n

         <\/p>\n

        When an organization\u2019s RCM process is disjointed and the front- and back-ends do not work in synergy,\u00a0your\u00a0staff will\u00a0have\u00a0to spend more time rectifying mistakes. On average, it\u00a0<\/span>takes at least a month<\/span><\/a>\u00a0for the typical practice to close a\u00a0bill on\u00a0patient services that are self-paid. To say that your\u00a0<\/span>administrative\u00a0team is already\u00a0overworked<\/span><\/a>\u00a0would be an understatement.\u00a0<\/span>\u00a0<\/span><\/p>\n

        Some studies suggest that the\u00a0<\/span>workplace environment is causing 80% of the burnout<\/span><\/a>\u00a0among medical professionals, with system-generated issues\u00a0being\u00a0the\u00a0leading\u00a0reason\u00a0for\u00a0day-to-day stress. Mountains of paperwork, long hours,\u00a0and unrealistic productivity\u00a0demands\u00a0\u2013\u00a0all\u00a0products\u00a0of a poor RCM process\u00a0\u2013 also contribute to that stress.\u00a0<\/span>\u00a0<\/span><\/p>\n

          \n
        1. \n

          The Patient Experience Suffers<\/span><\/b><\/h3>\n<\/li>\n<\/ol>\n

          Healthcare professionals,\u00a0like yourself,\u00a0know that the\u00a0cost of healthcare\u00a0will\u00a0continue\u00a0to rise, as is patient\u00a0financial responsibility\u00a0due to\u00a0an\u00a0increase\u00a0in\u00a0high-deductible plans.\u00a0Because of increased costs, patient experience expectations have\u00a0skyrocketed. Don\u2019t let\u00a0a disconnect in\u00a0your\u00a0finance department\u00a0derail your efforts to boost the patient experience.<\/span>\u00a0<\/span><\/p>\n

          No\u00a0one\u00a0wants to be surprised\u00a0by \u2018hidden\u2019 medical costs, especially\u00a0when those hidden fees are\u00a0a\u00a0result of\u00a0poor\u00a0clerical\u00a0processes.\u00a0Unfortunately, prior-authorization and eligibility mistakes directly contribute to an\u00a0increase in\u00a0out-of-pocket costs for\u00a0patients, especially as\u00a0high-deductible plans become\u00a0more\u00a0popular\u00a0and insurers are responsible for a significantly smaller portion of the bill.\u00a0<\/span>\u00a0<\/span><\/p>\n

           <\/p>\n

          The average U.S. family now\u00a0<\/span>spends about 11% of their income on healthcare<\/span><\/a>, and a quarter of those expenses are attributed to co-pays, deductibles,\u00a0and other out-of-pocket costs.\u00a0Patients are becoming more responsible for their healthcare costs, and\u00a0hospitals with better patient-paid\u00a0expenses are generally more profitable.\u00a0<\/span>\u00a0<\/span><\/p>\n

          According to the U.S. Census Bureau, a shocking number of Americans cannot afford to pay for\u00a0their\u00a0medical\u00a0care\u00a0\u2013\u00a0<\/span>nearly 20%.<\/span><\/a>\u00a0That means one fifth of your patients may not\u00a0pay their bill… ever.\u00a0<\/span>\u00a0<\/span>
          \n<\/span>Given these trends, practices should do everything in their power to\u00a0communicate\u00a0patient responsibility\u00a0when it comes to service costs.\u00a0The more transparent you are with your patients, the better chances\u00a0you have of\u00a0getting\u00a0paid. Your patient should know just how much their care will cost them, before ever stepping foot\u00a0into\u00a0an exam room,\u00a0and that is something an enhanced RCM process can help you with.\u00a0<\/span>\u00a0<\/span><\/p>\n

          Ready to Boost Your RCM?\u00a0<\/span><\/b>\u00a0<\/span><\/h2>\n

          If the previous problems sound all-to-familiar, then you should seriously consider investing in RCM support\u00a0designed to take some or\u00a0all of\u00a0the burden off your shoulders.\u00a0<\/span>Professional\u00a0RCM services<\/span><\/a>\u00a0provide you with billing and claims\u00a0support\u00a0to ensure you get paid\u00a0quickly.\u00a0<\/span>\u00a0<\/span><\/p>\n

           <\/p>\n

          RCM software\u00a0<\/span><\/a>can also automate\u00a0many of the tasks you’re already performing. Tasks\u00a0like appointment reminders, payment reminders, managing claims,\u00a0ensuring clean claim submission,\u00a0and\u00a0tracking\u00a0and re-working\u00a0denials.<\/span>\u00a0<\/span><\/p>\n

          Software can be used as a standalone solution, or it can be integrated with your Electronic Health Records (EHR) system\u00a0to\u00a0provide a\u00a0more\u00a0comprehensive view of\u00a0the patient\u00a0journey,\u00a0from intake to treatment\u00a0to\u00a0payment.\u00a0<\/span>\u00a0<\/span><\/p>\n

          RCM software can\u00a0also\u00a0assist in storing and managing patient billing records\u00a0to\u00a0potentially reduce the time between service rendered, billing, and reimbursement. This is done by\u00a0providing\u00a0you with a\u00a0more detailed look at patient populations.\u00a0<\/span>\u00a0<\/span><\/p>\n

           <\/p>\n

          In an industry where margins are already thin,\u00a0you need to be doing all you can to ensure reimbursement and clean claim submission.\u00a0When you spend too many resources\u00a0on the\u00a0bare minimum,\u00a0you place stress on your practice and\u00a0detract\u00a0from the patient experience. Discover how an RCM partner\u00a0can elevate your practice today.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

          In the highly regulated and fast-paced environment of healthcare, making sure your practice secures revenue and reimbursement\u00a0should be top of mind. However,\u00a0this task shouldn’t be\u00a0needlessly difficult and time-consuming.\u00a0Thankfully,\u00a0revenue cycle management\u00a0(RCM) support services\u00a0can\u00a0help fill in the gaps in your administrative billing processes,\u00a0so you can focus on what really matters, patient care.\u00a0\u00a0 Revenue cycle management\u00a0can be time-consuming […]<\/p>\n","protected":false},"author":1,"featured_media":43742,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,69],"tags":[443,84,207,444],"class_list":["post-24323","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revenue","category-show","tag-professional-services","tag-rcm","tag-revenue-cycle","tag-revenue-cycle-support"],"yoast_head":"\nFour Consequences of Poor Revenue Cycle Management - Continuum<\/title>\n<meta name=\"description\" content=\"When your practice leaves money on the table,\u00a0the\u00a0result is a poor financial condition,\u00a0a stagnated business, an\u00a0unhealthy working environment. 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