Evolve your cost cutting strategies with revenue recovery

Healthcare continues to be one of the most disrupted markets, and we see that trend set to continue for the next decade.

Healthcare continues to be one of the most disrupted markets, and we see that trend set to continue for the next decade. The cost curve continues to expand, while fragmentation and friction are still present and systemic. The Covid-19 pandemic placed a spotlight on system inefficiencies, redundancies and unnecessary recurring expenses. These strains and realizations resulted in internal audits and the need for aggressive cost cutting strategies. In order to create this holistic plan, your organization should have a clear understanding of current revenue gain opportunities.

So how do you find and implement these savings strategies?

Healthcare payers are notorious for underpaying providers, up to 8 percent for some of our national commercial payers! Additionally, they’re erroneously adjudicating claims with inaccurate pricing rules and edits causing false denials. In order to efficiently and effectively identify these disputes, your organization needs a contract compliance auditing system that will automate not only the identification process, but subsequently streamline your documentation submission and payer follow up. Many health systems may have a compliance platform adopted. However, in an ever growing system that’s strained for adequate resources, these work queues still manage to go unworked as their allocation priorities need to be assigned to working outstanding denials.

How much money is being left on the table? Millions!

Current client analysis found that up to $10 million annually could be found within this disputed payment category for a medium size health system. A shortage of resources should no longer be a reason for leaving millions of dollars on the table! Health systems should partner with companies to assist them in capturing this otherwise expiring revenue. Look for organizations with industry leading technology, coupled with a team of revenue cycle experts to fortify your Covid-19 response strategies, and begin recovering revenues that are rightfully owed to your organization.

If your organization is looking for more revenue and you want to learn more, feel free to reach out to me, Stephanie Rickard.