Revenue Leakage in Healthcare: What is It and How Do You Stop It?

revenue leakage in healthcare

Because revenue cycle management is complex, many healthcare providers neglect it and find their profits draining away. This is known as revenue leakage in healthcare, and it causes strain on many businesses in the US. 

At PracticeForces, we aim to remove every source of revenue leakage by providing premium medical billing and coding services. We are here to help medical practices succeed! Here’s a guide to actual revenue leakage and what healthcare businesses can do to avoid it.

What Is Revenue Leakage?

Revenue leakage starts when outstanding payments for billable procedures on various accounts go unpaid for long periods and providers don’t follow up on them. The longer a bill goes without charge, the harder it will be for physicians to receive payment for that service. If an account goes unpaid past 120 days, physicians will only see a 10% payout of that bill, if any.

Finding & Fixing Common Sources of Revenue Leakage

There is no singular cause of revenue leakage, so there is no one fix for the problem. The best way to stop it is to hire a revenue cycle management company to handle your accounts and keep track of payments. That said, these other strategies will help to eliminate revenue leakage in healthcare businesses.

Unbilled Claims

If a provider doesn’t file a health insurance claim for a client soon after the appointment, they may forget to do so. This oversight leads to a massive build-up of unpaid appointments. Providers should always match recent patient encounters to claims and routinely run reports on unbilled charges to find displaced funds.

Pricing Problems

Setting up prices for services rendered is a tricky business. If set too low, doctors won’t get paid what they’re worth. By contrast, setting prices too high will cause patients to look elsewhere for what they need.

Going by an external standard will keep your prices competitive. Do thorough research, and set fee schedules and regular rates based on Medicare rates and codes for each procedure. This will keep your revenue intact and result in the best pay for your work.

Faulty Claim Management

Because tracking denied claims is challenging, many healthcare providers don’t do it well, or even at all. Because of this, many denied claims end up lost and forgotten. If you want to keep all those denied claims from getting lost, hire dedicated staff to handle claim filing and establish protocols that keep you from losing claims.

Low-Quality Software Systems

While no computer system is perfect, a poorly-designed system will cause discomfort with use and lead to lost revenue because of forgotten jobs. You get what you pay for in the software industry. Pay for a decent, high-quality system to organize and save your accounts.

PracticeForces is your go-to source for all medical billing needs in the healthcare industry. We offer advanced technology and ways to improve revenue that help billing and claims processing. We endeavor to stop revenue leakage in healthcare practices across the nation.

Call PracticeForces at (727) 499-0351 to set up your services today!

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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