I read this interesting article on how the use of multiple RCM systems results in higher rates of denials as well as difficulties gathering and normalizing data. The HIMSS Analytics study said that denials are the biggest challenge hospitals face with revenue cycle management. One reason for that could be their use of multiple IT systems that do not mesh well together with various systems looking at numbers in different ways.
Seventy-six percent of hospitals – ranging in bed-size from 50 to 500 – said denials were the biggest challenge they faced with RCM – far more than revenue integrity (36%), patient pay (34%), collections (29%), and capturing ICD codes (27%). Of those having the most trouble with denials, 72.5% of respondents polled by HIMMS Analytics were using their electronic health record alongside three or more additional RCM systems to manage their revenue cycle.
As for data integrity – another big hurdle to getting paid – hospitals said lack of interoperability, and the fact that some systems are too siloed (67% each) were problems for their RCM strategies. When it came to gathering necessary data from disparate sources for reimbursement, nearly everyone said it was either moderately (65%) or extremely (33%) challenging. Similar numbers said the way revenue cycle data is collected is either moderate (59%) or big (38%) issue for their organizations.
The report also found that another big hurdle for hospitals trying to make better use of analytics to automate revenue cycle processes might be the use of too many disparate systems for their revenue cycle. Indeed, 41% of hospitals said they used their EHR with two or more other RCM vendors — some 16% are using two or more RCM vendors with no EMR. Additionally, more than one-third of respondents said that less than 25% of their revenue cycle process is automated with analytics creating seamless integrations across RCM solution. Parathon provides one enterprise RCM platform. Please visit www.parathon.com for more information.