RCM Effective Intelligence

Hospitals and health systems spend an estimated $40 billion a year on billing and collections. A system replacement changes the interface, not necessarily the economics.

In this guide, MedEvolve breaks down why a billing system replacement can leave the real problem untouched. You’ll learn how to tell whether your cost to collect is a platform issue or a workflow issue, how to prioritize claims by financial risk instead of age or balance, and how one MedEvolve customer grew to nine new centers without adding headcount by fixing the work, not the software.

Most AI vendor pitches are built around task-completion metrics: claims processed, calls placed, codes assigned, denials ‘worked.’ These numbers are easy to demo and easy to report. They are also, on their own, meaningless.

Provider organizations should adopt new methodologies for revenue cycle benchmarks to understand staff effectiveness and where breakdowns are occurring. These include the following measures along with suggested percentages for optimizing revenue cycle processes.

Provider organizations should adopt new methodologies for revenue cycle benchmarks to understand staff effectiveness and where breakdowns are occurring. These include the following measures along with suggested percentages for optimizing revenue cycle processes.