How Inefficiencies Are Fueling an $8 Billion Problem

Revenue Cycle Management (RCM) systems within healthcare organizations are integrated to streamline billing, accelerate reimbursements, and reduce administrative burdens. Billing solutions are supposed to be just that: solutions.

However, according to Black Book Research, 70% of healthcare professionals report dissatisfaction with their RCM software or outsourcing partners, citing a lack of automation, inefficient claims processing, and revenue leakage.

Despite advancements in healthcare technology, many RCM systems lack essential automation features such as AI-driven claims processing, predictive analytics, and automated denial management.

An $8 Billion Problem—and Growing

The financial impact of inefficient RCM systems is staggering. In 2017, U.S. hospitals lost $1.7 billion annually due to poor-performing IT systems. By 2024, that number surged to $8 billion, fueled in part by revenue cycle inefficiencies (Black Book Market Research).

For many providers, the inability to optimize billing and collections means a direct hit to their bottom line. Finances are not the only consequences of an inefficient RCM system, but also:

Slower reimbursement cycles: 79% of healthcare organizations report longer claim processing times and increased denial rates due to outdated, manual workflows.
Higher administrative burdens: Staff members spend unnecessary hours manually correcting errors and resubmitting claims.
Lost revenue opportunities: Without advanced automation, providers struggle with poor claims scrubbing, leading to preventable denials and revenue leakage.

What Needs to Change?

To reverse this downward financial trend due to outdated RCM systems, healthcare organizations must adapt and demand RCM solutions with advanced automation, AI-powered analytics, and integration with existing systems.

Despite the challenges in the medical office, countless healthcare IT leaders have no plans to replace their flawed systems in 2025. Financial constraints are holding practices back from actualizing their full financial capabilities, but delaying necessary upgrades only deepens the problem.

The future of healthcare revenue depends on efficiency—providers can’t afford to rely on outdated systems any longer. The time for change is now.

FAQs

We've compiled some of the most common questions practices like yours ask about the IrisMed. If you don't find the answers you're looking for here, please don't hesitate to contact us – we're always happy to discuss how IrisMed can specifically benefit your practice.

Do I have to change my practice management system or software to use IrisMed?

No. IrisMed is designed to be compatible with all major practice management systems. Our software seamlessly integrates with your existing setup, requiring no disruptive changes to your current workflow. We also offer white-gloved implementation and support if needed.

How much does IrisMed cost?

IrisMed offers flexible pricing models tailored to the size and needs of your practice. Contact us for a customized quote based on your clinic’s volume and workflow requirements.

Will IrisMed replace my existing staff members?

No. IrisMed is designed to augment and empower your existing team, not replace them. By automating tedious and complex tasks around insurance and quoting, IrisMed frees up your staff to focus on what matters most: providing exceptional patient experience and growing your practice.

My practice management system already has insurance and inventory features. Why do I need IrisMed?

IrisMed acts as a specialized enhancement for your optical sales, tackling complex vision plan details in a way most general PMS insurance features don't. IrisMed instantly deciphers intricate insurance benefits for specific lenses, coatings, and frames, providing precise patient out-of-pocket costs. More importantly, it helps your team uncover often-missed sales opportunities - like premium upgrades or second-pair allowances - right at the point of sale. Think of it as the tool that ensures your dispensary maximizes optical revenue and minimizes quoting errors where your PMS's broader features might not specialize.

How secure is my data with IrisMed?

We understand the critical importance of data security and patient privacy. IrisMed employs robust security measures, including end-to-end encryption and strict access controls, to safeguard all sensitive practice and patient information. We are HIPAA compliant and committed to staying up-to-date with the latest security standards and best practices in the industry to ensure your data is always protected.

How do I get started with IrisMed?

Getting started is easy! Contact us today to schedule a personalized demo. We'll show you how IrisMed works, answer all your questions, and demonstrate how our AI-powered platform can transform your practice's revenue cycle.