To bill correctly and collect funds while overcoming roadblocks along the way lies in the heart of every revenue cycle operation, whether you are a sizeable multi-location hospital conglomerate or a smaller facility. The 2020 pandemic shut down and almost overnight move to increased telemedicine introduced additional challenges that spotlighted the inefficiencies and new challenges in the back-end office processes. Processes such as coding and claims submission were experiencing numerous shifts with commercial payers and government new requirements.

Lori Intravichit, CEO of Sunlit Cove Healthcare, said:

All healthcare organizations struggle with not having enough staff to attack all avenues of revenue cycle management. Tasks such as coding backlogs, extended time in AR, compliance, and credit balances will lead to lost revenue.

As we learn to operate in a “new normal,” here are the top revenue cycle challenges to watch for:

1. Denial Mitigation

It could feel like a cat and mouse game sometimes. Staying on top of the rules and understanding what is going to get denied is critical. Get to know your payer and keep track of their tricks!

2. Outsourced Partnerships

Yes, you can get help! Your organization should not be afraid of outsourcing; it is not a bad word! In today’s ever-changing healthcare world, it should be embraced! An experienced partner can provide valuable expertise during various hospital projects to ensure that you stay on time and budget. Outsourcing allows your organization to supplement your team with top talent in the industry.

3. Cybersecurity

The healthcare-related Internet of Things must be protected! You have to account for all your internet access points. That also includes your remote workers, device manufactures, and anybody who is accessing your network. Any unsecured device could be potentially used as an entry point to your entire network that could be hacked or held hostage – better known as ransomware.

4. Relevant Reporting

It feels like that there will always be an emerging hospital crisis. Real-time data and understanding of the assessments and projects can help you navigate the next steps and what actions to take next.

5. AI & Automation

The average US nurse spends 25% of work time on regulatory and administrative activities. Imagine what would happen to patient care if every nurse gained 25% extra working time! It starts at the top of the organization. As a leader, you have to create a culture that embraces innovations and technology and find a way to overcome the objections of the adoption of AI within your workforce.

6. Virtual Care

The pandemic quickly proved many healthcare organizations wrong and established that telehealth could be a lifeline for many practices. After the pandemic – with a reasonable fee structure – people will spend less time traveling to and from healthcare facilities and still receiving high-quality care virtually.

The Sunlit Cove Healthcare team of revenue cycle healthcare experts is dedicated to supporting our customer's patient access from process improvement, interim management, policy and procedures to contracts, audits, vendor management, and training. We work with clients in a highly collaborative way ensuring financial and operational success! Contact us or give us a call at 727.576.2903 to get started.

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Sunlit Cove Healthcare Consultants

We provide management and consulting services to help healthcare businesses run efficiently. Navigating the dynamic and complex revenue cycle management is a challenge for many health plans, health care vendors, and providers. Our consulting services are available to assist with your day-to-day operations and provide expertise in growth and change management. We manage all aspects of your enterprise from the development of the revenue cycle management process to the completion of your business cycle.

Revenue Cycle Interim Management: