Empowering Revenue Cycle Health, Limiting Operational Fallout

Hospitals and health systems are scrambling to overcome unprecedented clinical and revenue cycle disruptions. According to an April 14th study by the MGMA, 97% of medical provider organizations have experienced a negative financial impact related to the COVID-19 pandemic. On average, providers reported a 60% decrease in patient volume and a 55% decrease in revenue since the beginning of the public health emergency. It is important that providers take steps to protect their revenue cycle operations, limiting the operational and economic fallout the pandemic is likely to produce. Issues with revenue cycle productivity, coding, collections, and claims resulting from COVID-19 can negatively impact cash flow and overall performance.

Healthcare revenue cycle tasks have traditionally been a largely manual process. Staff are responsible for analyzing each unresolved payment and associated payer rules to determine the underlying cause and what action needs to take place. This process consists of a lot of hunt, click, and type, extremely time-consuming and wrought with errors. Compounding the problem is the new work from home staff model, making it difficult to keep up with resource allocation and remote productivity.

As payer reimbursement models have become more complex and the volume of tasks increases, the ability of staff to keep up with increasing demands diminishes. Automation adds value to the process by taking the repetitive, routine tasks, applying business logic and completing the necessary actions, allowing staff to concentrate on items that require higher-level, human-to-human interaction.

Benefit and eligibility checks, as well as prior authorizations, are a perfect area to apply the power of automation. Administrative costs related to dealing with prior authorizations, plus the back and forth with payers, represents as much as one third of a physician’s compensation. Staff are required to call insurance companies, scour websites, make sure the patient has the right coverage, and enter everything manually into the system. It’s a very labor-intensive process, one fraught with errors. Automation brings improved accuracy and speed, reduces costs, and eliminates the frustration associated with this type of tedious tasking.

Claim denial management is another area perfect for automation in the revenue cycle.
The Advisory Board states, “You’re probably leaving $22 million on the table,” by not following best practices in four key areas: denial write-offs, bad debt, cost to collect, and contract yield. Boston WorkStation helps you achieve revenue cycle success, without leaving money on the table. Most of our solutions are developed and deployed within 30 days. One of our clients saved 180 hours per month and $20 million in failed claims re-submissions. Another recovered $2 million per year in ED billing, by automating auditing procedures, while a third saved 10 hours per day and $1.2 million per year by automating crossover claim processing.

Yet another way to optimize revenue cycle management tasks and reduce days in A/R, is through the use of a Productivity Dashboard, Dashboards provide key insights for revenue cycle managers, displaying customizable metrics in one place for greater process efficiency, financial transparency, and productivity of remote workers. Users are able to quickly identify issues and gauge the effectiveness of employees and operations in near real-time. The use of productivity dashboards to manage remote employees has provided managers with a daily snapshot of performance and priorities.

Whether in eligibility, claims management, collections, or productivity tracking, automation leverages technology resources and empowers human workers.

Why Boston Software Systems?
Boston Software Systems understands that people are driving the processes in caring for thousands of patients every day. Working as a digital ally, automation adapts to changing circumstances quickly, adding efficiency and supporting existing workflows. If you’d like to discuss how automation can benefit your revenue cycle, let’s talk! We won’t take up much of your time and can get things running quickly, usually within a few weeks, so you can realize a fast ROI.

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