Healthcare Organizations May Be Missing Revenue Opportunities Within Existing Processes
Wipfli's healthcare advisors highlight that many organizations are losing revenue due to inefficiencies in their existing workflows rather than a lack of patient volume. Issues such as registration errors, missed eligibility checks, and coding inaccuracies can lead to claim denials or underpayments before they reach payers. The firm recommends focusing on three key areas: preventing revenue loss early, protecting earned revenue during care delivery, and strategically recovering cash when it becomes stuck. For example, a single procedure code was denied 22 times due to incorrect insurance billing, resulting in over $500,000 in losses. Wipfli emphasizes that denial prevention is not just the responsibility of the billing department but involves multiple departments including eligibility verification and clinical documentation improvement.
Topics: cash flow management healthcare finance revenue leakage