Survey reveals healthcare providers’ RCM challenges

A new survey of more than 200 healthcare providers has identified the most common revenue cycle management (RCM) processes that cause delays and inefficiencies in their practices. The survey, conducted by a healthcare technology company, was released on Sept. 14.

These are the 10 processes providers said are getting most regularly backlogged:

1. Claim submission: 42 percent
2. Denial management: 31 percent
3. Patient collections: 31 percent
4. Prior authorization: 31 percent
5. Patient eligibility and benefits verification: 26 percent
6. Patient billing: 17 percent
7. Verifying fee schedule and contract with insurance company: 17 percent
8. Medical coding: 17 percent
9. Verify provider credentials: 17 percent
10. Reporting: 9 percent

Key insights

• The survey found that claim submission was the most frequently backlogged RCM process, with 42% of the respondents reporting it as a problem.
• Three other processes tied for the second place, with 31% of the respondents reporting backlogs in denial management, patient collections, and prior authorization.
• The fifth most backlogged process was patient eligibility and benefits verification, with 26% of the respondents reporting it as a problem.
• Four other processes tied for the sixth place, with 17% of the respondents reporting backlogs in patient billing, verifying fee schedule and contract with insurance company, medical coding, and verifying provider credentials.
• The least backlogged process was reporting, with only 9% of the respondents reporting it as a problem.

The survey results suggest that physicians are facing significant challenges in managing their RCM processes, which may affect their cash flow, patient satisfaction, and quality of care. The survey also indicates that physicians may benefit from adopting technology solutions that can streamline and automate their RCM workflows, reduce errors and denials, and improve communication and transparency with payers and patients.