In healthcare administration, there exists a critical juncture where financial viability meets operational efficiency: Revenue Cycle Management (RCM). RCM refers to the process of tracking and managing the financial transactions involved in providing healthcare services to patients. This process starts when a patient schedules an appointment and ends when the provider receives payment for the services rendered.
At the frontline of this intricate process are Chief Financial Officers (CFOs) and practice administrators. These professionals are tasked with the monumental responsibility of navigating the complexities of RCM.
From patient encounters to reimbursement, every revenue cycle stage requires meticulous attention to detail and unwavering vigilance. Yet, behind the scenes, there lies a world of burden and pressure that is often overlooked. However, it is deeply felt by those entrusted with steering the practice’s finances.
Navigating the Revenue Cycle: A Primary Challenge for CFOs and Practice Administrators
According to a recent report by the Healthcare Financial Management Association and Eliciting Insights (HFMA), health system CFOs spend nearly a quarter of their time on revenue cycle management.
RCM commands 24% of surveyed CFO’s time, followed closely by operations (18%) and cost management (17%). Strategy formulation takes 16%, while internal and external partnerships each claim 8%. Also, cash management and information technology occupy 8% and 6% of their time, respectively, with the remaining 3% dedicated to other essential tasks.
This breakdown underscores the multifaceted nature of the CFO and practice administrator roles, requiring a balanced approach to effectively address diverse aspects of organizational management.
The study also found that 82% of health system CFOs said payer denials are higher than pre-pandemic levels. The report added that 90% of CFOs said clinical and/or technical denials are a top problem for revenue cycle management teams.
According to the report, here are the top challenges for RCM teams:
- Clinical denials: 70%
- Technical denials: 63%
- Staffing shortages: 39%
- Underpayments: 33%
- Patient collections: 27%
- Third-party liability/complex claims: 18%
- Managing remote teams: 13%
- Other: 8.6%
- Credit balances: 4%
The HFMA Health System CFO Pain Points 2024 report is based on a survey of 135 health system CFOs conducted in January 2024.
At Health Prime, we can help!
Outsourcing your Revenue Cycle Management to Health Prime offers healthcare organizations access to expertise and resources that may not be readily available in-house.
Health Prime’s dedicated team of RCM specialists brings years of experience and industry knowledge, ensuring that organizations stay ahead of regulatory changes and industry trends.
Outsourcing your RCM with Health Prime reduces administrative burdens and empowers organizations to achieve greater efficiency and financial stability in an increasingly complex healthcare landscape.
By leveraging Health Prime’s expertise, organizations can optimize revenue generation, minimize claim denials, and streamline billing processes while freeing up internal resources to focus on delivering exceptional patient care.
Trust your RCM to us so you can return to what matters the most: your patients. Learn more about our services or contact us at [email protected]. Our team will set up a meeting to discuss how Health Prime can maximize your revenue by cutting costs, saving time, and collecting more!
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