Revenue cycle management options growing

Let's face it, when your income is derived from billing dodgy insurance companies, collecting is going to be a major challenge. However, of late there's been a growing number of vendors and consultants who say they can more or less resolve the issue--and many of them are putting a stake in the ground this year at HiMSS. Unlike many other types of vendors, many RCM technology developers have actually been in the healthcare delivery business themselves--so if nothing else, you can expect to have an educated conversation with most of them.

Most RCM vendors focus on making your facility or practice smarter in its dealings with insurers. Among the players are companies like athenahealth, a hosted service which allows office-based physicians to outsource the claims management and collections process more or less completely. Some vendors are touting practice management systems that have functions like eligibility, claims submission and editing built into the back end. Some EMR vendors say that they can help with this process too (though I'm skeptical that they have the payer knowledge base to do that just because they're handling your clinical data).

Other exhibitors, meanwhile, give you a leg up in collecting the portion of bills patients must pay directly. One particularly interesting example is Bluemark, whose platform helps providers assess the financial status of uninsured patients and qualify them for Medicaid or charity care programs. Another patient-collections option is hosted application services provider mPay Gateway, which helps providers collect patients' portion of their bill at the time of service. And there's options like Craneware's Patient Charge Estimator, which digs into a hospital's claims databases and helps prepare price quotes for procedures.

As patients pick up more of your bill, patient-collections platforms are likely to become as common as those targeting the health plan management process. Better patient collections is definitely worth exploring further at the show. After all, there's only so much you can do to speed up claims processing--so getting more on-the-spot cash from patients is worth a closer look.

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