How hospitals can transform AR management and productivity through their EHR: 4 insights for revenue cycle leaders

Providers today struggle with streamlining and strengthening their revenue cycle operations due to unstandardized workflows and inefficiencies on the AR front line.

To address these challenges, one of the nation’s leading health systems partnered with RCM technology provider Ontario Systems to eliminate the need for reps (“caregivers”) to make upfront decisions on accounts as well as reduce payer hold times and gain real-time performance insights—all from within the health system’s EHR platform.

At the Becker's Health IT + Revenue Cycle Virtual Event on Oct. 7, panelists discussed how these new capabilities are boosting caregiver morale and strengthening AR operations in various ways, from more connections with payers to more productive interactions that get accounts settled sooner.

The panelists were:

  • David Franklin, COO of Ontario Systems
  • Joe Keckan, senior director of revenue resolution at a large health system 

Here are four key takeaways from their discussion.

1. Some providers lack adequate tech support for AR workflow. Most reps move at their own pace and manually choose which accounts to work, because EHR systems don’t allow providers to take an assembly-line approach on accounts. According to Mr. Franklin, there is a lack of "intelligent decision making built into products and into the workflow, so it is a challenge for organizations to get the right account to the right person who can determine what to do next with it.”

2. Inefficiencies around decision making are significant, but can be overcome. By working with Ontario Systems, the health system rolled out an intelligent tech system that works within the EHR to determine schedule prioritization as well as which accounts to work on and when. Mr. Keckan said the tech "is able to make those decisions for [caregivers], allowing them to focus their time on value-added tasks such as dealing with payers or interpreting insurance responses.” Thus far, Mr. Keckan has seen a 120 percent increase in productivity for most of the AR team.

3. Simple tech tools can streamline and optimize payer communications. In addition to helping prioritize accounts, Ontario's EHR-compatible technology helps caregivers optimize payer interactions by using predictive analytics to determine the best time to call payers about specific accounts. While navigating payer holds and IVR prompts—key to the health system’s 46 percent decrease in average hold times—a "look ahead" feature shows caregivers which other accounts meet prioritization for that payer so they can bring up these accounts on the same phone call rather than having to call back later. 

4. Intelligent decision making increases accounts worked. After implementing Ontario's toolset, the health system's AR team is now approaching a 20 percent boost in accounts worked per hour. Mr. Keckan said this 20 percent lift is "largely coming from that ability to eliminate upfront work," adding that caregivers no longer need to navigate work queues, choose an account, or assess the actions needed as the solution organizes and prioritizes the workflow for them.

Click here to learn more about Ontario Systems. Click here to view a recording of the session.

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