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Per a recent HFMA survey, nearly 70% of leaders in healthcare revenue cycle are putting funds toward technology capable of improving the integrity of revenue, getting rid of human error, and boosting efficiency. Yet a major and largely unexplored opportunity for many companies to boost performance comes down to a familiar word: data.
Healthcare organizations still have a long way to go in areas like addressing out-of-pocket cost concerns with consumers, reducing collection costs, and cutting down on the rise of initial denial rates. A back to basics approach could be a viable solution even as digital automation becomes prevalent.
By performing some analysis, revenue cycle leaders can take a look at potential breakdowns during the revenue cycle process before they become a major issue. For example, an organization dealing with an unusually high discharged-not-final-billed (DNFB) rate can do analysis to figure which types of claims are stalling the claims submission process.
Data analysis provides revenue cycle leaders with a roadmap of where traditional claim processing failures originate and the forms of claim rejections and denials most commonly encountered. These may include additional documentation, failing to acquire prior authorization, or not filing on time.
To read more about the HFMA survey, visit https://guidehouse.com/insights/healthcare/2019/hfma-rcm-survey.
This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.