Even a cursory review of the latest healthcare news reveals that hospitals and health systems across the United States are looking to improve their financial outlook. With media headlines touting another round of layoffs at many health systems, the question becomes: Where and how can revenue cycle vendor partners step up to the plate and offset negative outcomes?
The relationship between vendor and client has evolved significantly since the pandemic. Conversations once conducted around conference tables now fall into a sea of un-read emails, with hospital executives struggling to catch up between back-to-back meetings. Increased communication and collaboration between vendor and clients is absolutely vital to meeting the demands of the organization and industry today. As a business partner, if you don’t have visibility to the financial goals of the organization each fiscal year, it’s hard to understand where you play a role. Conversely, if hospitals neglect to share their strategic and financial initiatives with business partners, it’s a missed opportunity for additional revenue.
The first step towards a better financial outlook is determining a good source of additional revenue. One often overlooked area is Out-of-State Medicaid claims. Next, finding the right partner to navigate the authorization and enrollment nuances of more than six hundred payors is key; they can mitigate the burden on your team while capturing incremental revenue. Taking the time to revisit workflows and processes will help ensure a successful collaboration.
While Out-of-State Medicaid is often a small part of the hospital’s overall accounts receivable, Centauri sees more than $2 billion dollars in placed claims each year. Given the complexities associated with these claims, many hospitals and health systems opt to write off these accounts. In doing so, they leave hundreds of thousands of dollars on the table each year -- dollars that could be used to offset negative outcomes they are experiencing.
The financial challenges in healthcare today are unparalleled, but not insurmountable. To learn more about how you can maximize your return on Out-of-State Medicaid, please visit https://www.centaurihs.com/out-of-state-medicaid.
Kelly Bauer, MS, CHFP
Director, Out-of-State Medicaid Division
Centauri Health Solutions, Inc.