Blog & Insights
Take the Pain Out of Revenue Cycle Management
Ensure Your RCM System Has These Three Critical Features
Revenue cycle management has long been a source of pain within healthcare. With so many moving parts — from initial contact management, to determining eligibility, gaining prior authorizations, monitoring claim statuses, staying on top of insurance follow-up, mitigating and managing denials, and collecting patient balances — managing it all can be a difficult challenge. Not to mention, you must do this while still ensuring a positive financial experience for patients, which is a critical aspect of overall patient satisfaction.
As if that wasn’t difficult enough, many RCM departments are struggling to attract and retain the employees required to accomplish all of this. And many of these employees now work remotely, which makes monitoring productivity and efficiency more difficult than ever.
Top healthcare executives and RCM decision makers are searching for RCM solutions that feature three critical components to help solve these pain points. These solutions must:
1) Provide intelligent, centralized automation.
2) Enable transparent workforce empowerment.
3) Humanize the patient experience.
Intelligent, Centralized Automation
Automation can provide many benefits but shouldn’t be implemented just for the sake of automation. Healthcare executives should look for an RCM solution that provides robotic process automation (RPA), machine learning (ML), and artificial intelligence (AI) to help reduce manual efforts and boost productivity. But beware that the solutions you invest in will not over promise and under deliver. Ultimately, you want to streamline RCM operations without disrupting workflows or breaking budgets.
Any platform you select must also seamlessly integrate with your existing system, including your EHR and other point solutions, to create a centralized platform that automates and streamlines your RCM efforts.
When you seamlessly integrate multiple systems into a single platform, you eliminate the navigation slowdowns that hampered your end users, helping to maximize their performance as well as optimizing their workflows and decision-making efforts. Your platform should leverage RPA, ML, and AI to segment and prioritize the highest yield accounts for optimized results. And it should include smart workflows that are controlled with RPA and AI technology and are adaptable and configurable, enabling you to mold the solution to fit your unique business needs.
— Healthcare organizations deploying Artiva HCx have found up to an 80% reduction in payer hold times, and a 60% boost in claim follow-up efficiency, resulting in more than a 20% improvement in revenue recovery rates. —
Humanizing the Patient’s Financial Journey
Patient satisfaction is a closely tracked metric, as it should be, which is why you need a patient financial engagement solution that lets you personalize your approach to financial care without leaving money on the table. Multipurpose patient portals and intake solutions designed for front-end and clinical purposes don’t meet the back-end financial needs required to optimize recoveries. It is critical to look for a solution that addresses the patient’s financial story and needs as a whole, and offers preferred communication methods and payment options to give the patient control of their experience.
The best solution keeps the patient, as well as the account representative, in mind, improving the experience for both. One way it can do this is by prioritizing accounts that require insurance follow-up and denial management. This will reduce delays and avoid unpaid payer balances becoming the responsibility of the patient.
An ideal platform also includes patient financial engagement tools and advanced segmentation strategies that use data points to determine a patient’s propensity and capacity to pay. It should also facilitate flexible payment arrangements, enabling account reps to treat each patient as an individual and care for their financial needs while driving recoveries.
— Healthcare organizations using Artiva HCx have achieved up to 70% of patient self-service. The flexibility of self-service enhances patient satisfaction—and revenue management—while freeing account representatives to work at the top of their license, managing complex cases and serving patients that need a more high-touch approach. —
Transparent Workforce Empowerment
Healthcare — along with just about every other employment sector — faces the challenge of finding enough employees for key roles, including account representatives and others involved in the entire patient journey. Though COVID restrictions are coming to an end, much of the workforce expects continued flexible work-from-home arrangements, with 59% of workers indicating they would choose employers who offer a remote work opportunity over those who do not.
If you’re an RCM leader considering remote and outsourced workforce solutions, you face the question of visibility into employee day-to-day activities and productivity. How do you ensure staff is working when they should be, and that they are following workflows and protocols while producing at the expected rate? It’s hard enough to measure employee productivity and efficiency when all are working in one building, let alone anywhere around the globe. You’ll need deep visibility to offer flexible workplace environments while ensuring your organization’s success.
A platform that includes workforce performance management tools equips end users to achieve outstanding results, while giving supervisors the visibility they need to manage and coach their teams. Workforce performance tools that include easily digestible KPI dashboards for account representatives, supervisors, and upper management are essential and allow for in-depth performance management regardless of where the employee is working.
Process adherence and quality assurance tools give supervisors confidence that staff are following prescribed procedures and protocols, while gaining the insights they need to improve workflows and processes to drive continuous improvement.
— Artiva HCx provides easy to digest KPI visualizations that improve process adherence and quality assurance, as well as end-user productivity. Artiva HCx clients have realized as much as a 20-point improvement in QA scores for account reps working from home, and a 62% increase in accounts worked per hour. —
Escaping the Pain
The pain points of revenue cycle management can be many. But with the right technology, the pain can be left behind. RCM decision makers are discovering substantial benefits from the deployment of a well-crafted RCM platform that seamlessly unifies efforts with intelligent, centralized automation, and combines AI, ML, and RPA to create a more personalized and humanized patient experience.
These leaders value the mission-critical visibility they’ve gained through transparent workforce empowerment, which gives supervisors and managers the adherence and quality assurance tools they need to ensure staff follow protocols while maximizing productivity and efficiency—whether working down the hall, from home, or across the globe.
Ready to learn more?
Visit our website for more information on Finvi’s RCM platform.