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New Challenges In Healthcare Revenue Cycle Management In 2014

By Expert Author: Michel Desuza

According to a survey conducted by Black Book, a market research organization, in 2014 healthcare organizations’ CIOs and CFOs are mostly concerned about how to get their RCM act together.

Almost all of them are convinced that there is no alternative to a comprehensive RCM solution if they have to keep up with changing regulatory needs and remain financially viable. But they have not been able to make nay considerable progress in having one because of cost and resource concerns caused by ongoing projects to meet more immediate operational and compliance goals.

For example, 28 percent of CFOs blame their lack of progress in upgrading to a holistic RCM solution on various technology and clinical projects underway in their hospitals. A CEO observes while organizations are engaged in RCM activities, they are mostly in the nature of day-to-day tasks like ICD 10 coding, insurance verification etc without any potential to change or upgrade their existing RCM process.
The survey informs that 63 to 88 percent of CEOs are convinced that their RCMs require to be replaced but their executive teams are divided on plans for implementation, urgency and timing. Similarly, there are varied opinions on vender count. While 85 percent of CFOs prefer a single-vendor solution, 77 percent of CFOs were found to be agreeable with any number of vendor – single or multiple – depending on the preference of their staff.

The survey found that the size of a healthcare organization can be a determinant of RCM modalities. CFOs of hospitals with over 250 beds prefer vendors with a proven record of providing sound financial solutions for facilities that are of smaller capacities; conversely, 87 percent of CFOs in facilities with beds numbering below hundred want RCM strategies solely based on their Clinical Information System (CIS) vendor relationship.

The views are myriad but where CIOs and CFOs concur is that they are convinced that a comprehensive RCM solution is the road ahead for their facilities in 2014 and beyond. However, as is evident from the demands and expectations, the RCM vendor, to really deliver and turn things around, has to come with the ability to put together an RCM solution (or upgrade an existing one) which meets the administrative, technological and operational needs of a healthcare system

MBC’s revenue management consulting can help you with this by performing a thorough analysis of your revenue management cycle and ensuring that there is sound coordination between various components of healthcare leading to smooth flow of medical data. Our RCM services involve identifying gaps in your process and addressing them by replacing, if necessary, old software applications with new ones, blocking areas of revenue leakage and identifying areas of staff training. We will help you develop a plan to facilitate transition to a stronger RCM platform without interrupting the flow of your day-to-day activities.


Medicalbillerandcoders.com, the largest consortium of billers and coders in the US, has also been helping several small, medium to big size healthcare providers with its Outsourcing services where MBC handles the entire range of activities involved in billing and coding starting from preparation of claims through submission to post-submission follow-ups. Our services are flexible which allow you to pick and choose only such parts of our offerings as suit your needs and thus keep your overhead costs low.

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