Revenue Cycle Management processes within a healthcare provider are critical to an organization’s financial viability. Yet, revenue cycle leaders struggle to control costs while keeping up with demand and reducing errors that can lead to lost revenue and patient dissatisfaction.
Over the last five years, the transition from ICD-9 to ICD-10, moving from 18,000 diagnosis codes to over 150,000, has cost large health providers an average of $2M–$8M through a combination of extensive training, high staff turnover rates, and increased claims denials and follow-ups.
While many tools have become available from electronic health records providers, clearinghouses, SaaS software services, and others to help improve parts of the revenue cycle workflow, many of these solutions do not seamlessly integrate with other parts of the value chain, and none provide holistic end-to-end functionality. This leaves providers in the position of managing the manual processes that bridge the gaps between these tools—essentially providing the “glue” via their internal teams. In fact, many organizations that have looked to new tool implementations alone to improve revenue cycle efficiency, reduce lost revenue, and decrease time to realize revenue have found that months after the new tools have been implemented, the business metrics they were hoping to improve have remained unchanged.
Because of the large quantity of repetitive, manual, and error-prone tasks involved in Revenue Cycle Management operations, it is estimated that 60% of functions can be automated entirely, and over 95% can be augmented with automation. This blog series explores how Intelligent Automation can provide benefits such as increasing revenue generated, decreasing operational costs, ensuring compliance, and increasing the speed to realize revenue across the following Revenue Cycle Management functions:
Realize revenue faster by proactively and continuously validating the status of claims to prevent your team’s time from being taken away from more critical work. This post explores the “quick win” outcomes Intelligent Automation can have by implementing automated payer status checks.
Providing up-front cost estimates to patients can significantly increase the likelihood of on-time payments. This post explores how quickly generating accurate cost estimates increases patient satisfaction and reduces collections without increasing administrative overhead on your team.
Prior authorization places a heavy burden on both clinical and administrative staff and is a key contributor to claims denials today. The process also has a negative impact on patient outcomes as care plans wait for authorization to proceed. Learn about the many ways that Intelligent Automation can be applied to reduce the burden of this process and improve clinical outcomes.
Learn how to reduce errors before claims are submitted and automate the bulk of straightforward denials to allow your team to focus on complex cases. Realize more revenue by reducing write-offs from cases that are not actioned today!
Explore the ways Intelligent Automation can provide the “glue” to tie together disconnected steps in the patient registration process or be the enabler of new registration capabilities entirely! This drives improved patient experience and ensures accurate information collection to drive claims processing.
Leverage Intelligent Automation capabilities like Machine Learning to identify incorrect coding practices driven through human error or fraudulent process. Learn how automation can help drive compliance processes in your organization.
pureIntegration has been partnering with our customers to automate their most challenging business and technical processes for over 15 years. We offer flexible engagement models and a factory approach to automation development—from building and maintaining automation long term as a managed service, or by building internal development expertise and an operations model (Center of Excellence) to drive automation initiatives, our team can get you off the ground quickly. Engage with us today to find out how to put 80,000 hours of automation experience to work for you!