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It is estimated that revenue leakage accounts for a loss of between 4-5% of total revenue in healthcare systems and hospitals. You, as a hospital administrator, should be concerned about the results of your revenue procedures. Make a switch to prioritizing net revenue maximization, enhanced coding, and compliance in order to build a scalable, error-free revenue cycle process that propels you to financial success.
Your health system might lose millions of dollars if modest income leakage is ignored. It is disappointing that most revenue cycle teams only meet less than once a month to discuss strategies for stopping revenue leakage and ensuring revenue integrity. And it's even more worrisome because as many as 60% of health systems don't have any sort of organized revenue integrity program.
Some sources of revenue leakage are:
Taking a data-driven approach to arresting revenue leakage and assuring revenue integrity is of paramount importance.
Auditing and identifying the primary income leakage sources is the first step in developing a revenue integrity program. If you work with the revenue integrity specialists at RM Healthcare, you can see dramatic improvements in your revenue realizations and bottom line.
Some sources of revenue leakage are:
Our precertification and authorization Services for inpatient and outpatient care are enabled by cutting-edge technological means.
We want to assist medical professionals in providing more complete and correct descriptions of the healthcare services they render. The following are some of the CDI services we offer:
As part of our charge capture audit Services, we check your bills for unrecognized chances to add new charges. Over/under billing can be uncovered by having clinicians participate in a thorough assessment of the procedure, documentation, and process. Together with billers, coders, and clinicians, we devise a plan to increase charge capture efficiency over the long term.
Coding Staffing : The standards for reporting and coding are always evolving. Whether you need assistance with coding backlog clearance, system transitions, regulatory reporting, or continuing staffing needs, we can put expert coders to work for you locally, virtually, or internationally.
Coding Reviews : We analyze and audit claims for correct usage of CPT and HCPCS codes and DRGs.
Coding Education : Through our coding audit and education Services, we ensure that all chart entries are correctly classified, and we detect instances of noncompliance, unbilled services, and incorrect coding. To add to this, we collaborate with coders and physicians to develop and implement targeted coding education and compliance programs.
To manage the appeals process and get properly repaid, we analyze claims that have been denied or underpaid. We also do root cause analysis to get to the bottom of difficulties in the front and middle of the revenue cycle.
