Introduction
Even the most diligent provider organizations can lose 5–10% of revenue each year—often without realizing it. Across nearly three decades of helping groups achieve high performance, JHDHP has seen preventable mistakes quietly erode the bottom line. Here are five common but addressable culprits, plus how to make them visible and actionable.
Broken Front-End Processes
Front-end issues like incomplete registration and skipped insurance verification undermine claims long before submission. Accountability, standardized workflows, and integration across systems are critical—and made visible by your data warehouse.
Ineffective Charge Capture and Reconciliation
Lagging charges, missed coding, and inconsistent reconciliation directly cause lost revenue. With busy teams and manual interventions, risk hides easily. Regular audits and integrated dashboards ensure every rendered service is billed.
Inadequate Denial Prevention
Denials caused by workflow errors or missing information can quietly drain cash flow. High performers stay under 2%—but many organizations are much higher and don’t know it. Robust denial dashboards powered by unified data make it possible to spot trends and fix root causes fast.
Ignoring Key Performance Metrics
Sustained success comes from tracking both results (Net Collection Rate, Days in AR) and processes (Eligibility Verification, Clean Claim Rate). Real-time KPI dashboards, blending EHR, billing, and PM data, enable quick action and true team alignment.
Lack of Continuous Improvement and Expert Resources
Change is constant—with workflows, payer policies, and technology always evolving. Top organizations bring in expert reviews and maintain a cycle of ongoing improvement, keeping RCM results above industry averages.
Conclusion
Are you ready to see what you’re missing? JHD Healthcare Partners uses world-class RCM methodologies and a proprietary data warehouse to spotlight hidden gaps and deliver rapid, measurable improvement.
