Maintaining regulatory compliance while managing hospital staff, caring for patients, and ensuring the highest standards of medical treatment is a complex and demanding endeavor that requires meticulous attention to detail, comprehensive training, and effective communication across all levels.
<strong>Identifying Key Regulations Impacting Revenue Cycle Management</strong>
Revenue cycle management is an essential aspect of healthcare operations that is subject to various legal and regulatory compliance requirements. These are the key regulations all healthcare organizations are likely to be subject to:
- EMTALA – the Emergency Medical Treatment and Labor Act of 1986 ensures greater public access to emergency services regardless of their insurance status and ability to pay.
- AKBS and Stark Laws – the Anti-Kickback Statute prohibits the abuse of the healthcare system for financial gain. The AKBS ensures that no healthcare professional or organization offers or receives any reward or financial incentive for an award or the referral of patients.
The Stark Law is a set of fraud and abuse laws that prohibit physicians from referring patients to other medical entities from which the referring physician or their family could receive financial gain.
<strong>Compliance Challenges in Hospital Revenue Cycle Management</strong>
To remain compliant, hospitals must address the following challenges:
<strong>Cybersecurity threats</strong>
Hospitals store confidential patient data that is worth a lot of money to hackers who sell it, making the healthcare industry a vulnerable target. It is crucial to update security systems and strengthen digital infrastructures at all levels – from hospital billing and coding to data entry and other components of the revenue cycle. Taking this for granted can put patient safety at risk and damage an organization’s integrity.
<strong>The rise of telemedicine</strong>
The pandemic has highlighted the relevance and usefulness of telemedicine in delivering patient care, but regulating telehealth remains a controversial issue because it is relatively new.
Still, hospitals must prepare to adopt telehealth services and, in turn, prioritize cybersecurity to protect sensitive patient information.
<strong>Hiring ethical and compliant professionals</strong>
The first step to maintaining compliance is hiring the right people. Organizations must strengthen their screening process to find the most ethical and compliant individuals to join their team. Having knowledgeable and experienced members will make it easier to keep up with the healthcare industry’s ever-changing regulations.
Promoting compliance may also mean placing the responsibility in the hands of trusted and experienced professionals who know best.
At Coronis Health, we never underestimate the importance of compliance in revenue cycle management. Our collaboration with the best of the best in revenue cycle management ensures we understand your facility's competitive landscape while keeping abreast of the latest regulations.
If you’d like to learn more about how you can remain compliant and keep your hospital billing optimized, contact Coronis Health to see how we can improve your revenue today.