BC Advantage - 2025 Issue 8
The Reimbursement Plateau: Breaking Through the Limits of Traditional RCM
Providers today face increasing pressure, especially when outdated revenue cycle management (RCM) is hindering their financial and operational performance. Collections from insured patients have fallen from 37.6% in 2023 to 34.4% in 2024 (as reported by techtarget.com), highlighting a growing gap between effort and revenue. Inefficient reimbursement processes are a major culprit, consuming valuable administrative resources, delaying crucial payments, and jeopardizing practice cash flow. The Persistent Problems With Traditional RCM Systems Traditional RCM systems rely heavily on manual processes, including paper checks, ACH transactions, and separate handling of electronic remittance advices (ERAs/835 files). Although ACH...
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