What are the three RCM challenges faced by the hospitals?

Answer 1

The healthcare revenue cycle is dynamic and continues to evolve. The three challenges of RCM are as follows

1. Lack of staff training:

If healthcare staff members are not trained effectively, they might not bill correctly or capture patient data correctly. Healthcare staff who are responsible for billing need to know how to properly capture a patient’s demographic information on the front-end, and how to translate that data to successful insurance claims after that.

2. Failure to monitor the entire claims process:

The claims process should be monitored closely at every point of its lifecycle. This is another important aspect of a provider’s revenue cycle management processes. If healthcare professionals do not watch claims closely, they won’t be able to figure out when an error was made. Additionally, they won’t necessarily be able to identify a coding issue. As a result, revenue can be lost.

3. Failure to have a financial policy:

Some healthcare facilities fail to have a financial policy documentation in place available for employees. These types of policies are an important part revenue cycle management. They should be available to employees electronically or in writing. They should also be reviewed by legal counsel.

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