Let’s face it: the administrative burdens in healthcare aren’t getting any easier. Documentation demands continue to rise to meet compliance measures, payer rules are ever-changing, and denial rates for claims just keep going up. In fact, a report by Change Healthcare estimates that the average hospital has $5 million in payments at risk of being denied each year. The good news is that 63% of those denials can be recovered. The bad? It costs about $118 in administrative costs for each claim to capture the money owed.

And the common cause for all these rejections in the first place is our industry’s continued use of manual processes. For instance, a big challenge for most providers is performing eligibility checks during patient intake but not rechecking before submitting the claim. Without using automation to recheck, there’s a heightened chance that the claim will be denied if coverage has changed during the lag time. This process breakdown in the revenue cycle might not even be detected for a month, but it can be felt for many months because of the resulting decreases in cash flow and increases in administrative expense and time.

But it doesn’t have to be this way with revenue cycle management (RCM) services offered in the HME industry. Providers using these types of services are finding 3 factors: scalability, expertise and analytics that significantly reduce the administrative burden on their staff and correct process breakdowns for efficient and profitable billing, collections and receivables.