The Challenges a Healthcare CFO Faces

The rising consumer expectations, complex billing cycles, and healthcare IT changes has resulted in more pressure for the healthcare industry. This makes the role of a CFO in this industry even more crucial!

In fact, according to a survey, a mere 13% of hospital CFOs are prepared to handle emerging healthcare models.

In our blog post we’ll talk about some of the most common challenges a healthcare CFO faces –

1) Challenges While Managing Denials

Efficiently handling your claim denials can increase your health center’s revenue while improving patient satisfaction. Which is why, revamping the claim denial process is crucial for most hospital CFOs.

As a CFO, you would primarily want to understand why these claims were denied!

This helps in enhancing the collections revenue but also prevents future claims from being denied. You would also want to ascertain the CPT for which your company is facing more denials.

2) Challenges in Predicting Patients Visits

Every hospital plans and predicts the number of patient visits for the fiscal year in advance, on the basis of historical trends.

As a CFO, it is challenging to keep track of the predicted visits with the actual daily visits.

It is also imperative to figure out the reason for decline in the actual visits and then take corrective measures to increase it in the following year.

The aim, therefore, is to increase the number of established visits along with increasing the new visits.

3) Challenges While Identifying Payors

As a CFO, it can be mind-boggling to identify which Payors (or insurance companies) are paying on time. The account receivables aging report sorts outstandings by 30 days, 60 days, and so on. For example, those who pay within 30 days are deemed good for business.

Since multiple payors have to pay back to the organization, it is therefore imperative to establish a successful payor strategy.

4) Challenges in Provider Management

A lack of accurate and reliable provider information leads to misrouted referrals and acts as a hurdle to patient retention.

Thus it is important for you to effectively manage and accumulate comprehensive information about the providers within your network.

It is a good idea to keep an eye on which health center is performing better than others, how many providers need to be moved to another health center and so on.

The other challenges that a hospital CFO might face are –

• Complex patient billing and claim lifecycles
• Siloed billing systems
• Incomplete translations of patient scheduling and registration information into ICD-10 codes
• Multiplicity of patient procedures and insurance types
• Follow-ups for rejected/unpaid claims

Key Takeaway

Healthcare CFOs must be able to provide direction to the organization by identifying revenue leakage and account receivables. With so many changes in the horizon, it takes a collective approach to address complex problems whereby everyone is involved in overcoming challenges as they arise.

To create the best approach that meets the needs of their staff and patients, it is crucial for leaders to engage in research and develop and assess issues.

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