As payment models shift, and the healthcare industry becomes increasingly complex, efficient revenue cycle management (RCM) practices are more important than ever. Practice management companies are at the forefront of this effort, helping healthcare organizations handle a myriad of administrative functions that involve patient engagement. Challenges often arise, particularly at the first patient encounter, related to incorrect or missing information. Practice management companies wanting to liberate themselves from these problems should look to automated RCM optimization tools, which offer a sophisticated way to streamline workflows and maximize revenue for healthcare customers.

Challenges in Traditional Practice Management Workflows

Sometimes the smallest errors can lead to the biggest revenue losses — especially when they go undetected over time. Problems often begin at the healthcare provider’s front desk, where patient information is collected. Whether the patient is using an app or registering in person, outdated insurance information, illegible paperwork, or data entry errors can result in faulty demographic and payer information. Errors or gaps in patient demographics make it difficult or impossible to find coverage, send bills, and may lead to denied claims. That can cause a cascade of other issues, including reimbursement delays and extra administrative work to fix the errors.

Another big challenge relates to managing patient payments, which is undeniably complex. Less experienced staff may struggle to accurately determine co-pays or coinsurance amounts, and patients end up leaving the facility without paying. This can add financial strain for medical practices because the chances of collecting outstanding payments drop drastically after that chance for initial, immediate collection.