How Vanderbilt Health's data-driven approach improved RCM operations

When the COVID-19 pandemic hit, Nashville, Tenn.-based Vanderbilt Health's revenue cycle team was in a better position than most to stay on top of claims thanks to a shift toward a more data-driven approach, according to a Nov. 1 Healthcare Financial Management Association article. 

That shift began in 2017 when the health system acknowledged "we were doing the same things over and over again and expecting a different outcome," Heather Dunn, Vanderbilt Health's associate vice president of revenue cycle said in the report.  

Data now helps determine which revenue cycle activities can be automated, its identifies claims that require staff intervention — like complex denials — and highlights opportunities to work directly with a payer to adopt a more strategic approach, according to the report. 

Vanderbilt has 43 process automation bots in its revenue cycle and about 1.8 million records automated. 

"At Vanderbilt, the work we've done to clean up our internal infrastructure and produce better, cleaner claims, strengthens our position with payers," Ms. Dunn said. "Now we expect the same level of commitment from payers — and that's a different conversation than we've had in the past."

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