In the complex world of healthcare, obtaining a successful revenue cycle management (RCM) means constant effort, which can be quite stressful.
Managing DME (Durable Medical Equipment) billing claims in fact is becoming increasingly challenging with each passing days. A recent survey of healthcare leaders highlighted that today claim denials pose a serious and expensive problem for healthcare organizations.
Understanding the Challenge in DME Billing:
According to a survey conducted by Plutus Health, healthcare organizations with annual revenues ranging from $ 25 million to $ 5 billion identified claim denials as their most significant RCM challenge, with 58 percent of respondents ranking it as their top concern. This issue ranked even higher than specific payer challenges, staffing issues, cost of collections, and policy changes such as The No Surprises Act.
Denials management, a crucial stage in the RCM process, is often backlogged, as indicated by nearly 42 percent of respondents. The financial toll of claim denials is substantial, with 22 percent of organizations losing more than half a million dollars in annual revenue due to denied claims. And for 10 percent of organizations, claim denials result in losses exceeding $ 2 million annually.
Addressing the Priorities:
In response to these challenges, 43 percent of healthcare organizations have identified denials management as a top priority for the year. Additionally, other RCM priorities include patient eligibility and benefits verification (38 percent), prior authorization (32 percent), claim submission (29 percent), and patient collections (26 percent).
The Role of RCM Solution Here:
Even though managing DME billing can be quite overwhelming at times. There are RCM solutions that can play a pivotal role in helping healthcare organizations achieve their RCM goals. Approximately 64 percent of respondents who implemented RCM solution expert in their healthcare operations reported faster cash flow and collections. Moreover, some experienced more insightful and readily accessible business analytics, while few percentages saw improvements in supply chain management. Some respondents even noted enhanced patient flow and scheduling.
So now that you know RCM organizations have the potential to prevent costly claim denials as well. Around 20 percent of respondents reported improved efficiency in filing claims, while 16 percent noticed a reduction in data entry errors since incorporating RCM processes. In fact, today more DME providers are inclined to opt for the option of outsourcing.
Overcoming Hesitancy - Sunknowledge a Unified Approach:
In light of these statistics, healthcare organizations are focusing on unifying the RCM process to remove silos and improve the integrity of their revenue. More than a quarter (27 percent) of respondents plan to invest in educational resources for their internal RCM teams, while 21 percent intend to seek guidance from trusted external advisors.
Managing DME billing claims effectively is pivotal for healthcare organizations seeking to improve their revenue cycle management. Addressing claim denials, a pressing issue, requires a multifaceted approach that organization like Sunknowledge Services Inc excel in. Helping you with seamless DME billing operation with technology, staff training, and process improvement; Sunknowledge decade old solution also known for highest productivity metrics. In fact, partnering with Sunknowledge you can unlock new efficiencies, reduce denials, and ultimately enhance RCM operations.
So if you are struggling with DME claims? Sunknowledge is the one stop solution in this ever evolving healthcare landscape in mastering DME billing claims. It is a critical step toward financial sustainability and success.
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