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"The biggest challenge that we have at the present is unique to our facility because we opened a brand new hospital in August 2012. A lot of IT resources are being funneled there, which means there are fewer resources to help the revenue cycle automate processes."
Without increased automation, Palomar is leaving money on the table when it comes to collecting from payers, Nguyen says.
"There is an explanation of benefits attached with a payment, and payers tell us what they are paying and what they are denying. Let's say they pay $5,000 of a $6,000 bill. When the payer denies, how do you know if they are right? Right now we have to eat that cost, but the technology will be able to check and appeal denials. Automation technology could really help us to overcome some of these challenges."
At Marin General, funding concerns are centered on the hospital's construction projects.
"Our particular challenge is funding significant capital needs while we continue to improve operations and build our balance sheet," Cox says. "Our hospital disaffiliated from a larger system several years ago, and we were left with very little liquidity and significant unfunded capital needs."
The organization has employed several strategies to meet its funding difficulties, Cox says.
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