4 recent RCM tips

Here are four revenue cycle management tips from industry experts, published by Becker's Hospital Review on or after June 28.

1. "By not committing to a robust [claim] denials program, organizations can miss prime opportunities to strengthen revenue integrity and speed cash flow, leaving critical money on the table. An effective program involves a change in mindset, moving away from reacting to denials after they occur to proactively identifying patterns and implementing targeted performance improvement strategies to address issues and keep them from recurring." — Amber Iuliano, product manager of denial management at Waystar

2. "By proactively scrubbing claims using machine learning, providers can head off potential issues by comparing current claims to previous patterns of denials. They can then make corrections, such as improving coding accuracy, before claims are submitted rather than after, helping improve cash flow as well as significantly reducing the cost of reworking claims." — Deepti Sharma, director of product management at HSBlox

3. Eric Nilsson, chief technology officer of the SSI Group, a revenue cycle solutions company, recommended establishing a holistic security framework to improve cybersecurity. He specifically advocated for using the Health Information Trust Alliance, a nonprofit focused on keeping sensitive information safe and managing risk for healthcare providers. "HITRUST has designed the security framework that allows you to manage both risk and security in your healthcare organization," Mr. Nilsson told Becker's Hospital Review. "[Its] framework rationalizes relevant regulations and standards into a single overarching security framework."

4. "Providers should take a page from online retailers and make it easy for healthcare consumers to understand why treatment costs are what they are. The good thing is that many providers want to offer the information to patients by using automated cost estimation solutions.

"With the right data and technology in place, a future visit to a healthcare provider may seem, from a billing standpoint, more like the local supermarket, which would be a positive development for healthcare in general and support healthcare consumers who want to know more about their care and understand why things cost what they do." — Allen Latham, vice president of revenue cycle management at TriZetto Provider Solutions, a Cognizant company

 

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RCM tip of the day: Use technology as part of a denials program

 

 

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