{"id":3115,"date":"2017-03-16T09:50:46","date_gmt":"2017-03-16T09:50:46","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=3115"},"modified":"2026-03-23T07:54:19","modified_gmt":"2026-03-23T12:54:19","slug":"heres-what-weve-taught-healthcare-cfos-and-revenue-cycle-directors-about-rcm-and-compliance-auditing","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/heres-what-weve-taught-healthcare-cfos-and-revenue-cycle-directors-about-rcm-and-compliance-auditing\/","title":{"rendered":"Here’s what we’ve taught healthcare CFOs and revenue cycle managers about RCM and compliance auditing"},"content":{"rendered":"
[vc_empty_space][vc_custom_heading text=”Here\u2019s what we’ve taught healthcare CFOs about revenue management” font_container=”tag:h2|text_align:left|color:%23ff6600″ google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:700%20bold%20regular%3A700%3Anormal”]
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Battling reimbursement challenges, shrinking margins, and compliance hurdles hospitals are exploring options to cut back on costs and increase revenue. The decision to work with professional\u00a0revenue cycle management companies<\/a>\u00a0can be tied back to the bottom-line pressures healthcare organizations face. A survey by Black Book reflects this trend.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n

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According to the survey,\u00a054% of healthcare CFOs believe outsourcing will help them improve their financial health<\/a>. And that the outsourced RCM market is growing at a 27% rate. 49 percent of hospital CFOs said outsourcing, including offshoring, is becoming an extremely viable option in 2017.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”But there is a blip in the bubble\u2026” font_container=”tag:h3|font_size:25px|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:700%20bold%20regular%3A700%3Anormal”]
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Okay. So moving RCM functions out of the office seems to be just what the doctor ordered. But the disturbing and recurrent pattern of healthcare CFOs, routinely switching RCM systems and offshore companies brings to light the fact that an ill-informed decision is akin to flying from the frying pan to the fire.<\/p>\n

Before taking the quantum leap it is imperative that the revenue cycle management directors and CFOs conduct a thorough revenue cycle audit. Why? Because the revenue cycle of a hospital has a lot of moving parts and\u00a0identifying poorly performing areas enables CFOs to know what to outsource<\/a>\u00a0and when and to whom.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”Case in point” font_container=”tag:h2|font_size:25px|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:700%20bold%20regular%3A700%3Anormal”]
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Okay. So moving RCM functions out of the office seems to be just what the doctor ordered. But the disturbing and recurrent pattern of healthcare CFOs, routinely switching RCM systems and offshore companies brings to light the fact that an ill-informed decision is akin to flying from the frying pan to the fire.<\/p>\n

Before taking the quantum leap it is imperative that the revenue cycle management directors and CFOs conduct a thorough revenue cycle audit. Why? Because the revenue cycle of a hospital has a lot of moving parts and\u00a0identifying poorly performing areas enables CFOs to know what to outsource<\/a>\u00a0and when and to whom.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”A thorough revenue cycle audit should consist of\u2026” font_container=”tag:h2|font_size:25px|text_align:left|color:%23000000″ google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:700%20bold%20regular%3A700%3Anormal”]
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1. Medical coding audit<\/strong>
\n2. Contract performance audit<\/strong>
\n3. AR audit<\/strong>
\n4. Denial prevention audit<\/strong>
\n5. Compliance audit<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div><\/div><\/div><\/div><\/section>

[vc_custom_heading text=”1. Coding Report- A dashboard for better coding practices” font_container=”tag:h2|font_size:25px|text_align:left|color:%23ff6600″ google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:700%20bold%20regular%3A700%3Anormal”]

Medical coding errors when left undetected pose significant financial and compliance risks to a hospital. An\u00a0independent assessment of medical coding processes<\/a>\u00a0will bring to the surface coding inconsistencies and errors. This will in turn equip hospital CFOs to select a revenue cycle company that has an expert coding team on board. Or outsource their coding process alone instead of their entire RCM.<\/p>\n

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\u00a0For more information on Part A and DME, please visit\u00a0CMS<\/a><\/p>\n

Don\u2019t end up with binders full of useless information. The code auditing report should provide actionable data and not just lame, random numbers.<\/p>\n

Your coding report should:<\/h3>\n