Biggest Reasons Why Medical Practices Fail to Maximize their Revenue When we talk about medical practices, we are referring to hospitals and doctors, who are more commonly known as healthcare providers or simply providers. They diagnose, cure, advise or prescribe medicine for ailments. The fact is that even though the main task of providers is to treat patients they still need to maximize on their revenue to stay afloat. Especially in this day and age when the competition is severe. The healthcare expenditure in the U.S. is characterized as the most costly per person compared to all other countries and despite this, the quality of healthcare outcome is low. Industry News: According to the World Health Organization (WHO), the total health spending was approximately 17.9% of its GDP, the highest in the world. Aggregate hospital costs are $387.3 billion, which is a 63% increase since 1997. The health share of GDP is expected to reach 19.5% by 2017. The government spends about 45% to 55% on healthcare. The provider industry is pegged at $296 billion with an annual growth of around six percent. Failure in Maximizing Revenues From the data above one understands that there are several opportunities for the healthcare industry in the US. However, there are several reasons why they are not being able to maximize their revenues: Front office systems and procedures are weak: We have seen that the providers keep on following the same old technique that has been in existence. They do not try and refurbish the way the office runs. The systems that are being used in the front office or the ERP or program that the provider uses is outdated; due to which they are not being able to keep up with the latest changes; which results in providers not being able to maximize their revenues. Bills contain inaccurate and outdated codes: The bills that are being raised many a times contain outdated codes due to which the payer does not process the bill. This results in medical practices losing out on their revenue.
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