Cycle Up

Is your healthcare organization taking advantage of innovative tech-driven solutions to achieve financial resilience? If not, you may be losing ground financially.

On Friday, September 22, the Consumer Financial Protection Bureau (CFPB) announced it has begun the rulemaking process to “remove medical bills from Americans’ credit reports.” For more than a year now, the CFPB has taken aim at the Fair Credit Reporting Act (FCRA) slowly chipping away at legal, proper practices of the nation’s healthcare providers and their partner collection agencies with false and misleading claims.

In the first three months of 2023, approximately one-third of inpatient and outpatient claims submitted by providers to commercial payers went unpaid for more than 90 days. Many were outright denied. (Source: Becker’s Hospital CFO Report).

Claim denials that were once reserved for a sliver of expensive medical treatments have become a more common occurrence for ordinary medical care. Current payer practices combined with AI and computer algorithms are denying claims by the thousands every month.

Healthcare systems are slowly recovering from the financial pressures of COVID-19. Though margins are moving in the right direction, they still remain slim.

The Good News

Most hospitals with Medicare claims are missing more than $1 million in revenue that is owed to them and waiting to be retrieved. Though Medicare provides reimbursement for $3.5 billion per year for Medicare bad debts, hospitals typically underreport those debts by 4% – 7% every year. That’s earned cash not hitting the bottom line.

Claiming the Gold

While healthcare provider margins are slowly ticking up this year, most hospitals, health systems and physician groups ran negative numbers in 2022. In fact, last year was the worst financial year in history for providers.

In spite of recent financial stresses, there has never been a better time to identify and recover missing revenue. Many organizations have well over $1M in cash owed to them that they can claim and collect.

In the Summer 2023 edition of AAHAM’s The Journal of

In each edition of Cycle Up, we sit down with one of the leading voices in the company. In this issue, we’re talking with Dave Frank, Vice President of Comprehensive Business Office Outsourcing, to discuss strategies for spotting and correcting a dysfunctional revenue cycle.

Healthcare providers nationwide are still grappling with the impact of COVID-19 on staffing shortages and thin financial margins. That is why we have just launched Episode 2 of our award-winning podcast series – Solutions for Staffing Shortages that Accelerate the Revenue Cycle.

In this episode, Meduit’s Jeff Nieman, CEO, and Greg Rassier, Chief Strategy Officer, discuss:

If you missed the Meduit/HFMA KY webinar Top Tech-driven Tools Changing the RCM Game, you can watch it now.

Learn how healthcare providers are leveraging leading digital tools, artificial intelligence and automation to generate revenue, reduce costs, stabilize finances and ensure economic resilience from Jeff Nieman, CEO of Meduit, and Jason Petrasich, Sr. Vice President of AI for Meduit. Access the webinar here:

For the fourth year in a row, Meduit has been named one of the top healthcare revenue cycle companies in the nation based on total contracts data, as reported by Modern Healthcare’s annual survey for 2023. We believe this is because of our dedication to providing innovative solutions, such as technologies driven by artificial intelligence, that achieve financial resilience for our healthcare provider partners.

Have comments or questions regarding an article in this issue or a topic you’d like our editorial team to consider for an upcoming issue? Send us your thoughts at info@meduitrcm.com. And be sure to like and follow us on social media: