Emerging Trends in Denial Management for Inpatient Hospitalization

Inpatient Hospital accounts receivableManagement of accounts, especially with inpatient hospitalization, can be increasingly challenging for the providers. It is important to note in this aspect that insurance companies have a specific set of guidelines with their claims adjudication process.

♦ Hence, it is important for the practices to have a disciplined understanding of the regulations so that they can implement the right practices that will help them gain subsistence with the insurers.

♦ One of the key aspects that need mention with Inpatient Hospital accounts receivable is the reduction of the TAT with a synchronized recovery process in place. In-house employees often face hindrances with patient care & managing receivables in the right earnest.

♦ Today, technology innovations are demystifying the healthcare industry & they are looking to adopt processes that will provide them steady automation with comprehensive quality in place.

Truly, hospitals have to look for the right avenues that will help them achieve transparency in their accounts receivable as well as excellence in their care management solutions.

Some of the key trends that are witnessed these days in Inpatient hospitalization will be:

The emergence of outsourcing: Today, there are multiple RCM vendors who are providing cutting edge solutions with their disciplined expertise. They have a flexible partnership model & competitive pricing that can be as low as 1% of the total collections earned. It gives the hospitals leeway to function effectively with an ROI of proportion in place.

Reduction of TAT with rapid automation: Another important aspect is the utilization of portals & query systems during A/R follow-ups. State of the art outsourcing companies looks to have customized platforms that give them access to insurer’s database understanding the correct reason for denial. It helps them rectify the process & resubmit with prompt reimbursements.

Dedicated A/R experts: The team of the RCM companies is experienced resources who have an extensive understanding of the payor’s claims evaluation process. They apply their skill-set with innovative best practices that allow consistent cash flow for the hospitals. The management of aging accounts, as well as current accounts, is done with HIPAA compliance that generates almost 97% collections.

Surely, it can be concluded that outsourcing of inpatient hospital accounts receivable services is a positive step for health care providers who are looking to yield dividends in collections with a keen focus on patient treatment.


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