Rapid industry changes and economic stressors brought about by the COVID-19 pandemic have left healthcare provider organizations seeking ways to streamline operations and increase efficiencies. Applying automation within the healthcare revenue cycle is one path to achieving these goals. The repetitive and consistent nature of managing credit balance processes can make this an ideal place to start.
Why credit balances?
Credit balances are ubiquitous in hospitals’ patient accounting systems. A typical revenue cycle employee at a medium-size hospital takes approximately 15 minutes to resolve a single credit balance account.1 With organizations needing to resolve thousands of credit balance accounts each month, the result can be countless staff hours devoted to researching, pulling data, and reviewing accuracy of accounts. This is often on top of employees’ normal day-to-day workloads and can easily be addressed in more efficient ways. Incorporating automation into credit balance management can help revenue cycle teams resolve large quantities of credit balance accounts in less time, freeing up the workforce to work on resolving the more complicated accounts that have a greater level of uncertainty and ambiguity.
By not resolving credit balances in a timely fashion, organizations leave themselves vulnerable to several risks, including missed revenue (credit balance accounts might hide funds that could be collected from secondary, tertiary, or self-pay payers) and misstated revenue on financial statements.
In addition, organizations could be subject to financial penalties resulting from noncompliance with regulatory requirements, or even legal action. Organizations also could increase their risk of being subject to third-party audits, such as costly multistate unclaimed property examinations. Automation can help revenue cycle departments resolve credit balances faster and potentially mitigate these and other risks.
