Using Technology to Benefit Your Financial Outcomes
Your healthcare organization is facing challenging times as it looks to optimize its revenue cycle performance while freeing up capacity to investigate the potential transition to a Pay-for-Value. While Pay-for-Value captures the headlines, the current reality is these plans are only vaguely defined and still largely in the development stage. As you invest time and energy in evaluating these future options, how do you ensure that the lifeblood of your financial performance- insurance reimbursement- is as optimized as possible?
Automate, automate, automate. It is the simplest way to overcome the complexities and challenges that claims place on your revenue cycle results. Automating charge review and charge correction is key to improving your financial outcomes because manual charge capture is time consuming, error prone, and it adversely affects your ability to provide quality care by compromising revenue precision.
As Health Management Technology reminds us, the revenue cycle touches on nearly everything related to healthcare – from the time a patient books an appointment with a healthcare facility, until the patient and insurance company provide final payments for services rendered to the healthcare provider. Claim denials can be disastrous.
The most successful forms of automation can help lower your staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt – all contributing to enhanced profitability, improved financial outcomes and, potentially, improved patient satisfaction.
Here are five ways automating your charge data will transform your RCM:
- Clean your data at the most efficient spot – the front end. Traditional claim scrubbers sit at the back-end of the process, after charge transactions have been posted to your revenue cycle management system (RCM). This is inefficient. A front-end solution, with a robust data model and modern, sophisticated technology that can easily integrate with your existing EMR and RCM system is the most powerful and robust way to clean your data. It virtually eliminates the need for time-consuming charge correction and re-post efforts.
- Find a system that allows for automatic data correction. An automated review and transmission of charges into your billing system ensures that clinical encounters are appropriately and compliantly formatted with the payer’s billing and administrative requirements.
- Implement a system with a customizable healthcare rules engine. This will allow you to get paid faster with less effort. It will also ensure that you can quickly and easily create or modify rules to meet your evolving requirements, ultimately improving your financial performance.
- Rule-writing capabilities are critical for your success. Use a system that easily integrates with your existing RCM system so that you can write rules against your own specific data elements.
- Finally, the right automated system will reduce the number of times your staff needs to handle claims. It provides sophisticated options that ensure claims are clean and organizes patient billing information to aid in collections. This is an important step in revenue cycle management.
Remember, automation is the key! The changing healthcare landscape will continue to challenge your resources and potentially threaten your budget. Striving for excellent patient care and outcomes always come first. But a close second is keeping revenue flowing and ensuring that you are collecting all that is due to your practice. Learn how RCxRules can help your Revenue Cycle. We’ll see you soon.
