Brookfield, Wis.-based Fi-Med, a provider of revenue cycle management, subscription analytics and chronic care management services, argues implementing risk-based analysis solutions could help lower healthcare organizations' risk of bankruptcy.
Hospitals and health systems see significant profit losses due to various revenue cycle-related issues such as declining patient payments, penalties due to overbilling, decreased reimbursement and higher debt levels, among others, said Fi-Med in a news release. These significant profit losses can lead the organization to declare bankruptcy.
"It takes tremendous effort for hospitals to get to the root of coding issues that cost them millions of dollars, and many healthcare facilities simply don't have the manpower to perform such a task. In holding to the status quo, hospitals risk a visit from governmental auditors who could determine that the hospitals have been overpaid — and the money then has to be repaid. It's a position no hospital administrator wants to be in, especially if the facility is already experiencing financial distress," said Adrian Velasquez, CEO and founder of Fi-Med.
Therefore, he recommended hospitals and health systems consider incorporating analytical software into billing programs as a potential solution. Mr. Velasquez said this analytical software may include the company's REVEAL/md subscription service, which examines healthcare organization billing data and reveals providers that are a compliance risk.
He added, "Hospitals can help to avoid audits that lead to bankruptcy by using analytical tools that flag major risk factors before it's too late. In identifying coding errors early, it's certainly possible to remain in compliance with the rules and dodge the bankruptcy bullet."