Every year brings new challenges for healthcare facility leaders to address. In 2024, prompt patient collections, increased denials, and staff shortages are typical concerns for teams. While these obstacles can be overwhelming, technology — including patient payment portals and automated insurance eligibility validation — can make a world of difference in your collection processes. Most importantly, partnering with an experienced vendor can optimize your revenue cycle management and stay ahead of the curve.

1. Timely Patient Collections 

A recent report found that almost half of revenue cycle leaders see timely patient collections as their most significant roadblock. More patients miss payments due to factors like the rise of high-deductible plans, increased patient responsibility, and complex collection systems. RCM teams must meet the challenge with streamlined patient payment solutions and billing processes. 

Flexible payment tools like online and mobile payments make it easier for patients to pay and stay ahead of due dates. Within these platforms, patients can view their statement information and pay with the click of a button. On the operational side, these tools can improve efficiency, reducing workloads and delays that occur when patients need to call the office. 

Digital payment solutions and a unified patient portal can help you simplify the collection process with features like:

• Mobile Pay
• Text to Pay
• Photo capture bill payments
• Real-time chats
• QR-enabled statements

Secure patient self-payment software can help reduce accounts receivable aging and help you maintain a solid cash flow. Mobile Pay makes it easier for patients to conveniently pay on their phones wherever they are, and Text to Pay offers real-time SMS communication so patients can pay within seconds. 

Revenue cycle leaders must also stay updated on best practices so they can educate their patients. That’s why most portals include a real-time chat system where live agents can answer questions and assist in taking payments. Informing your patients about their financial responsibilities and being upfront about costs can clear misunderstandings and improve your RCM. 

2. Managing Denials

Another healthcare RCM 2024 concern is managing denials. One report found that 90% of health system CFOs claimed clinical or technical denials were a top concern for RCM teams. Approximately 82% of CFOs reported payer denials were higher than pre-pandemic levels. Proper insurance verification is crucial to reduce claim denials, with accurate coding and billing at the core of revenue recovery.

Healthcare RCM solutions involve proper coding of procedures, diagnoses, and services. An effective healthcare RCM system ensures insurance eligibility on the front end and an insurance updater on the back end. The platform streamlines the pre-arrival and arrival stages of the patient experience, automatically validating insurance information to help you prevent errors and denials.

Using these tools will confirm your patients’ insurance information, verify the provider is in their coverage network, and determine the patient’s responsibility. Patients will be ready to pay their copay when they arrive for their appointment. Providers can communicate with patients through their portal if their insurer denies a claim. 

Automatic insurance validation can increase the chances of claim acceptance on the first submission, reducing administrative costs associated with processing and reworks. Over time, effective RCM healthcare solutions can result in millions of dollars in additional revenue for the average facility. 

3. Hiring and Training Staff

The healthcare industry faces significant staffing shortages, particularly within RCM. The crisis has overloaded employees with administrative tasks while reducing the quality of patient care. Staffing shortages in RCM are particularly concerning, given its critical role in billing and payment management.  

Due to an industry-wide labor shortage, hiring new staff isn’t always the best option. In these cases, partnering with an outside RCM company is ideal. Outsourcing your billing and calls leaves you more time to train and hire staff, as technology can relieve administrative burdens. Patient-facing tools can reduce employees’ stress and let you focus on critical tasks.

• Automatic insurance eligibility verification: Virtual intake forms and real-time insurance eligibility verification can reduce the time spent on the phone. Patients receive a text asking them to enter their information and can even take a picture of their credit or debit card to reduce human error.  
• QR-enabled statements: For example, QR-enabled statements and Text to Pay options automate and customize electronic and print statements on your behalf. The technologies eliminate the need for patients to call, allowing them to quickly scan or text to complete payments in seconds. 

These digital options give patients multiple ways to pay, reducing the need to call a representative. Intuitive interfaces and user-friendly features can also simplify training, reducing the learning curve for new hires and optimizing efficiency. Plus, working with a reliable agency gives you access to expertise and knowledge to improve your operations without hiring more employees. 

4. Outsourcing to Too Many RCM Vendors

Another challenge RCM teams face is work overload due to managing too many vendors. The resulting human error and burnout will reduce your efficiency and ability to provide outstanding patient care. Partnering with a vendor that offers the technology and services you need in one place can improve your revenue collection processes and relieve strain on workers.

Unified patient collection solutions eliminate the need to find multiple vendors. With centralized patient payment solutions, automated tools, and technologies, you can streamline administrative tasks, reduce the costs of staff turnover and training, and increase your revenue. Outsource your healthcare RCM to one vendor and appreciate an end-to-end digital platform to grow your facility. 

Partner With Millennia for Effective Healthcare RCM Solutions

About The Author

Scott Sanner

Scott, the current CEO of Millennia, brings nearly 30 years of healthcare industry experience. Scott served as the CEO of Citra Health Solutions, held senior positions at McKesson and Change Healthcare, including oversight of Communication and Payment Services, and was Senior Vice President and General Manager of Accountable Care Services. Prior to that, Scott was the Senior Vice President and General Manager of Technology Services at MED3000 and McKesson. Scott began his career at Misys Healthcare.

See author's posts