Blog & Insights
Look for These Three Essential Components in Your Next RCM Solution
Hospitals and other healthcare organizations are outsourcing revenue cycle management more than ever before. It’s a tough job and getting harder all the time. RCM outsourcers operate within a very demanding environment, which includes shifting insurance requirements, patients facing increased financial responsibility, growth in denials (with some payer denial rates up to 80%), a staffing crisis, and managing an increasingly remote workforce that works with multiple, often disparate, systems.
The world of healthcare seems to be reeling. There’s been a 68% rise in deductibles since 2011, and 2020 saw a 47% increase in bad debt. Sorting out all of this is difficult for account representatives—and the patients they work with. Technology is supposed to come to the rescue, but without the right RCM technology solution, it is difficult for account reps to work efficiently, hard for managers to gain visibility into productivity, and hence, impossible to maximize revenue.
Too frequently, account representatives operate in an inefficient environment of multiple data sources and vendor solutions. This poorly integrated collection makes it difficult to navigate and time-consuming to gather the data needed to work their accounts.
Such disjointed systems lead to account representatives relying on manual processes, increasing the likelihood of human error as well as significantly slowing the speed to payment. The lack of visibility into performance inhibits a manager’s ability to provide coaching and insights to improve processes and results.
Outsourcers can greatly enhance their operations and profitability by ensuring they have the right RCM technology platform, because the right platform can turbocharge your workforce. Some of the biggest revenue drains are tied directly to your ability to empower your staff to work smarter, not harder. Doing more with less isn’t about reducing head count; it’s about making the best use of the talent you have.
These challenges make it more critical than ever to select an RCM solution that helps end users achieve success through workflow automation and performance transparency, resulting in a more humanized patient experience and improved revenue cycle outcomes. When shopping for a new RCM solution, be sure the system includes the following three mission-critical elements:
- Data-driven decision making.
- Results acceleration.
- Resource maximization.
Data-Driven Decision Making
As organizations are trying to do more with less, your RCM solution must maximize resources across your organization, maintain staff and client satisfaction, and separate yourself from the competition. It must eliminate navigation slowdowns with its integration across systems, while providing automated account presentation that aligns with your business strategy and automating redundant tasks through RPA and AI technologies. Robust contact matching and account connecting reduces the time account representatives spend on balance follow-ups. And embedded patient engagement tools increase timely payments while enhancing patient satisfaction.
Look for an RCM solution that gives you accurate insights into workforce and workflow behaviors, enabling you to create an enhanced workflow environment that optimizes staff performance. By ensuring your staff are working the accounts you have prioritized for prior authorization, insurance follow-up, denial follow-up, and patient pay needs, you can propel performance by focusing efforts on your highest value accounts and tasks, and surfacing the trends and results needed to make strategic business decisions.
Your RCM solution should equip supervisors with tools to manage in-office as well as remote staff, giving them real-time monitoring capabilities to track activities throughout the day, enabling them to follow up for quality assurance, adjust activities in real time, and set realistic goals at the individual and organizational level. With digestible views of performance and results for end users and supervisors across business lines, account statuses and types, individuals, responsibilities, and more, you gain visibility to the behaviors and trends needed to make business decisions that will further growth.
Results Acceleration
When evaluating RCM systems, be sure that the solution you choose allows you to personalize each patient’s journey with tools that give account reps a better understanding of each patient’s financial capacity. Ideally your platform should expand clientele and inventory options, speed onboarding, and reduce denials and write-offs while enabling reps to simultaneously work on similar accounts. By offering patients multiple self-service options, timely payments are increased while your reps are free to give that extra customer service to those patients that require it.
Providing insight into their performance coupled with purposeful automation, individual team members are able to work at the top of their license, allowing them to focus energy on higher value tasks and accounts that improve their ability to achieve their target goals.
To meet today’s demands, your system should be scalable and repeatable with plug-and-play configurations for streamlining, consistency, and speed to onboard new clients, as well as new employees. An intuitive UI makes life easier for staff and patients, and strong workforce management tools make it easier and more efficient to supervise staff and increase productivity—whether located centrally or remote.
Resource Maximization
As organizations are trying to do more with less, your RCM solution must maximize resources across your organization, maintain staff and client satisfaction, and separate yourself from the competition. It must eliminate navigation slowdowns with its integration across systems, while providing automated account presentation that aligns with your business strategy and automating redundant tasks through RPA and AI technologies. Robust contact matching and account connecting reduces the time account representatives spend on balance follow-ups. And embedded patient engagement tools increase timely payments while enhancing patient satisfaction.
Look for an RCM solution that gives you accurate insights into workforce and workflow behaviors, enabling you to create an enhanced workflow environment that optimizes staff performance. By ensuring your staff are working the accounts you have prioritized for prior authorization, insurance follow-up, denial follow-up, and patient pay needs, you can propel performance by focusing efforts on your highest value accounts and tasks, and surfacing the trends and results needed to make strategic business decisions.
Your RCM solution should equip supervisors with tools to manage in-office as well as remote staff, giving them real-time monitoring capabilities to track activities throughout the day, enabling them to follow up for quality assurance, adjust activities in real time, and set realistic goals at the individual and organizational level. With digestible views of performance and results for end users and supervisors across business lines, account statuses and types, individuals, responsibilities, and more, you gain visibility to the behaviors and trends needed to make business decisions that will further growth.
Great Resource for a Tough Task
Revenue cycle management has perhaps never been as challenging as it is today. To address these challenges, you need a comprehensive yet user-friendly platform that removes barriers and eases friction to drive increased payments and account resolution. It must include the tools to optimize your processes across the entire revenue cycle continuum.
That’s why leading RCM outsourcers leverage Finvi’s data-driven workflow solution to maximize resources and accelerate financial outcomes – transforming the payment journey for their clients and patients.
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