Ask any hospital CEO or CFO, “what is the biggest day-to-day problem you face?” You will most often hear, “We don’t get paid what we are owed.” The breakdown goes something like this:
Commercial Insurance, “we get about 50% of what we charge, if we’re lucky.”
Medicare, “we get maybe 40% of what we charge.”
Medicaid, “we are lucky if we make anything” And finally,
Self-pay. “Don’t even ask!”
With this being said, it is just that much more important that your hospital is running on all cylinders to make sure that all of the remaining money that you’re entitled to comes out at the other end to your hospital. There are many reasons why the money that your hospital “should” be getting is not making its way to you!
Below are a few reasons:
These in turn can lead to:
The advent of the EMR has caused many more financial problems than it has solved.
If this sounds familiar, maybe you need to look at obtaining outside help in the administration of your Revenue Cycle Management. Companies like ours have built in processes and systems that allow us to address every one of these items consistently and persistently. We believe in this process so much that we work on a contingency basis, so we are incentivized to obtain for your hospital every penny that it is entitled too.
If you’d like to get more of the money you are entitled to, please call us.