The Top 10 Revenue Cycle Issues Facing Hospitals in 2022

February 16, 2022

Jon Giuliani
Vice President of Operations

  1. PRICE TRANSPARENCY.The back-end work is complex. The data requirements are enormous. And making a user-friendly and informative portal is daunting. Hospitals will require expert technical assistance. There will be a cost, but the cost of non-compliance outweighs the initial investment.
  2. LAB PAMA REPORTING.Medicare extended the deadline for certain hospitals and clinics which meet the description of an “Applicable Laboratory” to report private payer lab rates to the first quarter of 2023. It’s a reprieve–for now. But knowing if you’re one of those certain hospitals or clinics may require expert help.
  3. NO SURPRISES ACT.While providers and medical associations are voicing their disappointment in the NSA arbitration process, they are generally supportive of the NSA. That being said, implementing the requirement will continue to be a priority for hospitals.
  4. APPROPRIATE USE CRITERIA.Medicare moved the deadline for OPPS hospitals and interpreting radiologists to comply with reporting requirements to January 1, 2023. But that doesn’t mean hospitals can rest. Work throughout 2022 will be required to comply with these requirements.
  5. STAFFING CHALLENGES.The inability to adequately achieve a full cadre of qualified revenue cycle employees directly impacts a hospital’s cash flow and financial performance. This, in turn places immense pressure on capital and operational needs.
  6. ADMINISTRATIVE COSTS.Keeping the doors open will continue to drain resources and reserves as hospitals face rapidly rising administrative costs. The challenge for hospitals will be in finding ways to stem the tide of rising costs and potential red ink.
  7. AR RECOVERY & RESOLUTION.Exacerbated by staffing shortages, pursuing aging, small-balance claims will gain better success by using a dedicated, specialized team ensure quicker cash conversion and a reduction of bad debt reserves.
  8. CLAIM DENIAL MANAGEMENT.Hospitals will need to increase their reliance on intelligent automation and staff specialization to efficiently process all claims, regardless of size or age, for hospitals. This will contribute to cash flow and improved operational management.
  9. INVOICE & PAYMENT PROCESSING.Medical practices–whether hospital-owned or independent–cite patient collections as a top revenue cycle struggle. Providers are now challenged to create invoicing and payment systems that are easy for patients to use and that offer a variety of payment options. Providers are also required to follow strict guidelines to protect patient information, making it even more difficult to create a patient-friendly portal that encourages users to pay in a timely manner.
  10. IMPROVING THE PATIENT EXPERIENCE.Healthcare organizations face tough competition in attracting and retaining patients who demand an experience that matches the level of customer service they expect from other consumer experiences. For organizations offering a variety of services in different locations, it becomes even more challenging to provide accurate and up-to-date information from one centralized database. Here is where the patient portal becomes either most valuable, or most challenging.

ParaRev offers a full spectrum of healthcare revenue cycle management services, from front-end charge master analysis and contract management to end-of-cycle zero-balance denial recovery. We’re committed to working seamlessly with your hospital financial and billing staff to minimize denials and bad debt, improve collections and boost revenues.

ParaRev has three operational divisions focusing on the core pillars of the healthcare revenue cycle:

  • RevCap, the revenue capture services division, supports primary and secondary AR recovery resolution, targeted denial resolution and zero-balance underpayment recovery. 
  • RevTeg, revenue integrity services division, provides contract analysis, coding and compliance services and market-based pricing analysis. 
  • RevTek, the revenue technology services group, offers ParaPath, our revolutionary denial decision software, and ParaRev Data Editor, a robust web-based single source solution for pricing, coding, reimbursement, and compliance, along with price transparency, contract management and payer scorecard tools.

ParaRev’s comprehensive capabilities, when aligned with hospital internal teams, can help hospitals improve operating margins and collect additional revenue. Contact ParaRev for help in overcoming the top 10 issues facing hospitals and health systems in 2022!

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