Effective revenue cycle management (RCM) can help providers optimize their cash flow opportunities, streamline the verification of vital account information, improve charge capture, shorten timeframes from discharge to final bill, reduce the amount of claims denials and much more. But as many benefits as RCM offers, there are equal, if not more, challenges that it faces.
Here are some of the biggest RCM challenges the healthcare industry has faced in 2015:
ICD-10 Implementation
Although health systems and providers have been given numerous extensions to the ICD-10 launch date, time is up, and the transition will inevitably happen this October 1st. Will providers be ready? Will payers be ready?
Depending on who you ask, the delays to launch …show more content…
Keeping patient information secure is becoming increasingly complicated. Since 2009, there have been over 800 patient data breeches and over 25 million patient record affected by HIPAA violations, hence the second phase of HIPAA audits that started this year.
While fines for HIPAA violations start as low as $100, they can go as high as $50,000 and cap off at $1.5 million annually, depending on the scale of the breach. You may be thinking you don’t have to worry about HIPAA violations or the fines that come with them because you are a small- or medium-sized practice, but that’s unfortunately not the case. With so many breaches the result of carelessness with mobile devices, employee theft, or poor social media habits, practices of all sizes are at risk for breaches and the resulting penalties.
Meaningful Use 2 (MU2)
Physicians were already challenged with meaningful use and things didn’t get any easier in 2015. This year saw the implementation of the 1% decrease in Medicare reimbursements for those eligible professionals (EPs) who did not attest for MU2, as well as a full 12 months of reporting, as opposed to the previous 90 day window. Many physicians have found it troubling that the Centers for Medicare and Medicaid Services (CMS) didn’t make things easier with their frequent rule changes, requiring providers to constantly stay up to date with the agency’s latest FAQs (like they have nothing better to
Here are some of the biggest RCM challenges the healthcare industry has faced in 2015:
ICD-10 Implementation
Although health systems and providers have been given numerous extensions to the ICD-10 launch date, time is up, and the transition will inevitably happen this October 1st. Will providers be ready? Will payers be ready?
Depending on who you ask, the delays to launch …show more content…
Keeping patient information secure is becoming increasingly complicated. Since 2009, there have been over 800 patient data breeches and over 25 million patient record affected by HIPAA violations, hence the second phase of HIPAA audits that started this year.
While fines for HIPAA violations start as low as $100, they can go as high as $50,000 and cap off at $1.5 million annually, depending on the scale of the breach. You may be thinking you don’t have to worry about HIPAA violations or the fines that come with them because you are a small- or medium-sized practice, but that’s unfortunately not the case. With so many breaches the result of carelessness with mobile devices, employee theft, or poor social media habits, practices of all sizes are at risk for breaches and the resulting penalties.
Meaningful Use 2 (MU2)
Physicians were already challenged with meaningful use and things didn’t get any easier in 2015. This year saw the implementation of the 1% decrease in Medicare reimbursements for those eligible professionals (EPs) who did not attest for MU2, as well as a full 12 months of reporting, as opposed to the previous 90 day window. Many physicians have found it troubling that the Centers for Medicare and Medicaid Services (CMS) didn’t make things easier with their frequent rule changes, requiring providers to constantly stay up to date with the agency’s latest FAQs (like they have nothing better to