RCM Analytics in the New Normal and Beyond
The competition in the healthcare sector is quite intense with the emergence of new players every now and then. Added to that, the current pandemic situation has put enormous strain on the global healthcare system with a massive spike in incoming patients. All these lead to billing errors, poor reimbursement process, and dissatisfied customers, Thus making Revenue Cycle Management (RCM) a challenging process.
We all know, deadlines and large volumes can have an adverse impact on efficiency. This is exactly what the healthcare providers are currently experiencing.
Most of the healthcare agencies are now focusing on the implementation of cutting-edge technology for RCM.
Be it policy renewal or medical coding, be it claims disbursement or claims renewal, the chunk of data collected can be utilized to produce meaningful insights with the implication of right tools. It helps a healthcare provider to improve their services and have a better understanding of insurance trends and customer behavior.
Benefits of Analytics in Revenue Cycle Management
Analytics play a big part in better management of the revenue process.
- Preventing Common Mistakes with Prediction
You can enhance revenue management by predicting denials at the right time. More often than not, common billing errors hampers the cash flow and revenue management process. With proper analytics, patterns from the previous data can be utilized to prevent the repetition of the same mistakes.
Once you identify the root cause of the majority of billing errors like underpayments, you can implement proactive measures to increase efficiency.
2. Establishing KPI for Better Efficiency
Key Performance Indicators (KPIs) are indicators of progress made towards the achievement of a pre-defined goal. In simple words, KPI are stepping stones of business. To ensure that a business is moving in the right direction, it is important to establish proper KPI.
A proper KPI-analysis is very important when it comes to revenue cycle management.
Here are some important KPIs that you need to monitor using proper analytics:
- Claims turnaround
- Percentage of clean claims submission
- Status of pending insurance claims
- Denial rate
- Determination of AR value
- Denial recovery percentage
- Number of new registration
3. Auditing of Action Areas
Performing a thorough audit in all departments is a time-consuming and lengthy procedure. RCM analytics can make a huge difference.
With the latest analytics tools powered by innovation, organizations can easily identify cases of overcharges and undercharges. With proper and timely identification of payment discrepancies, organizations can easily quantify uncollected amounts. Organizations can also utilize this to adopt effective strategies to deal with it instead of completely writing-off bills receivables.
4. Improving Accounts Receivable
There is no denying the fact that accounts receivable is the favorite part of any business balance sheet. Any business wants a handsome figure in the accounts receivable section of the balance sheet.
By utilizing the data available from analytics, the accounts department can find out patterns to improve the figures.
A Few Words Before Winding Up
Implementation of data analytics to healthcare business is certainly the way forward. Seamless integration of RCM and HCM integration with proper analytics reduces billing errors, minimizes workload on employees, and eliminates billing errors.
The top companies are using cutting-edge solutions for Revenue Management like ExdionRCM solutions.
ExdionRCM solutions are powered by AI, ML & RPA and help to achieve stellar efficiency, optimize RCM using automation, enhance productivity, and deliver a superior customer experience.