“Checking In” on Revenue Cycle Management Emerging Trends

Several trends are driving consolidation in the Revenue Cycle Management (RCM) sector – one of the most rapidly consolidating sectors within the healthcare industry.

Vendors are proudly promoting branded engagement tools, emphasizing unique approaches to optimizing inpatient DRG reimbursement, shifting their focus to complex claims, and automating as many solutions as possible with keywords like “remote process automation.”

• The Millennia Complete platform is drawing attention for its fully integrated end-to-end patient engagement interface that offers payment processing services, patient access services, and patient recovery services. 

• The middle of the revenue cycle is a hotbed of activity. Accuity is a strong example of a company that has experienced substantial growth assisting health system clients across the country in reviewing their charts to ensure their clients are coding claims optimally to avoid missing out on the appropriate fee amounts for service reimbursement. 

• Several vendors are promoting solutions for complex claims services, with businesses like Elevate and Revecore highlighting streamlined processes for managing third-party liability accounts, workers’ compensation, veterans’ administration, and COB denials.  

• Finally, Meduit offers a differentiated example of how RCM companies use robotic process automation. Its Avadyne subsidiary’s augmented reality capabilities and proprietary avatar helps patients navigate their medical bills, recognize speech analytics, and improve patient financial satisfaction.

Providers are finding that the skyrocketing costs in travel nursing, disruptions to the supply chain, and continued challenges with recruiting and retaining talent are making outsourced RCM staffing firms more important than ever before; especially companies with the staff and capabilities to properly obtain prior authorizations, overcome denials, and get claims paid. With so much innovation and differentiation across the revenue cycle, continued acquisitions and investments in unique services and capabilities should continue for the foreseeable future.

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