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Exceptional Coders | Innovative Technology

Average Hospital Leaves $22 Million on the Table Due to Poor Revenue Cycle Performance

Posted by David Fong on Nov 28, 2017 6:30:00 AM

The Advisory Board Company in a press release earlier this year announced that the average 350-bed hospital has an overlooked opportunity of up to $22 million in revenue capture. Improving revenue cycle performance to decrease missed revenue opportunity means responding to four market forces.


These four market forces are increased patient consumerism, driven by higher financial obligations; aggressive commercial denials and more complex payer contracts; physician engagement on documentation given demands on the acute care and medical group enterprises; and poorly executed integrations that waste potential economies of scale.


As an example of worsening trends, proprietary Advisory Board benchmarks show that median performing organizations have stagnated on net days in accounts receivable -- and the overall average cost to collect worsened by 70 basis points of net patient revenue from 2011 to 2015, amounting to millions of dollars for many hospitals.


Commercial payers are scrutinizing more claims than ever, meaning increased denials. Hospitals are losing, on average, five percentage points of their margin to underpayments and denials, according to the press release.


Don’t leave money on the table! To overcome this growing trend in lackluster revenue cycle management, healthcare organizations need to avail themselves to companies, such as Aviacode, that are experts in managing coding-related denials. They can provide cost-effective solutions for revenue recovery to ensure that appropriate payment is received for services provided.


Denied claims are lost money, especially when claims never get resubmitted. Sifting through the thousands of denial reasons to identify and correct coding-related errors is time consuming and costly. In-house administrative staffs are often ill-equipped or lack the time to tackle this monumental task, so it never gets done.


Aviacode’s expertise and price structure provide a cost-efficient solution for revenue recovery that ensures the appropriate payment is received for services provided. We have the capacity to meet your needs and will efficiently and cost-effectively identify and correct coding-related errors, allowing you to collect the money you are owed. Our denials team is also committed to improving your coding-related denial management process so you can free up cash and increase revenues.


Our coding denial management process uses a highly effective workflow and processes which include top certified coding professionals. Outsourcing your coding denial management to Aviacode will help you increase income, reduce lost reimbursements, and maximize your ability to collect unpaid claims.


Topics: Medical Coding, HIM, Denial Management