Hospitals

With all the talk about electronic medical records and meaningful use, it’s easy to put health information exchanges (HIEs) on the back burner. But that’s not an option. Communicating in a digital healthcare world without HIEs is like trying to navigate a highway system with no freeways.

Comprehensive, accurate, up-to-date and accessible information on healthcare providers is a key to successful healthcare business management. Most organizations, however, have neither accurate nor up-to-date information on their providers. Moreover, information that is captured is contained in multiple silos, reduced to paper files, rarely shared and never used to control costs.

The transition from ICD-9 to ICD-10 – mandated to occur by Oct. 1, 2013, for organizations subject to the Health Insurance Portability and Accountability Act (HIPAA) – is expected to improve care-management quality and enhance reimbursement accuracy. The transition, however, is expected to be costly and labor intensive; the Department of Health and Human Services (HHS) estimates the cost to providers alone at $3 billion through 2017.

Increased profits, streamlined operations and a strengthened financial position are all benefits of the right type of RCM implementation.

A successful revenue-cycle management (RCM) program creates opportunities for healthcare providers to increase profits, streamline operations and strengthen the financial backbone of their practice or institution. RCM implementations also provide opportunities for things to "go wrong." When not addressed, certain obstacles can impact the level of adoption, efficacy and financial impact. By taking into account the most-common problem areas, healthcare providers can increase their chances of a successful program.